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Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system.
Pediatr Emerg Care. 2008 Aug; 24(8):505-10.PE

Abstract

OBJECTIVE

To identify clinical variables associated with a greater likelihood of emergency department (ED) revisit for acute asthma within 7 days after an initial ED visit for acute asthma exacerbation.

METHODS

Cross-sectional study of subjects from a prospectively enrolled cohort of children aged 0 to 18 years with physician-diagnosed asthma in the ED Allies Tracking System. Demographics and data on quality of life, health care utilization, environmental factors, chronic asthma severity, and ED management were collected. Emergency department revisits for acute asthma within 7 days of a prior visit resulting in discharge were compared with those without a revisit, using chi2 and t tests and logistic regression.

RESULTS

Four thousand two hundred twenty-eight ED asthma visits were enrolled; 3276 visits resulted in discharge. Persistent asthma was identified in 66% of visits. Emergency department revisits within 7 days of a prior visit occurred following 133 (4.1%) visits. There were no significant differences in environmental factors or ED management between visits with and without an ED revisit. In univariate analysis factors associated with a greater revisit likelihood included age younger than 2 years, black race or Hispanic ethnicity, persistent asthma, public insurance, lower quality of life, and greater health care utilization in the prior 12 months. Variables independently significant (P < 0.05) in logistic regression were chronic asthma severity classified as persistent, age younger than 2 years, and lower asthma quality of life.

CONCLUSIONS

Although our design precludes drawing causal inference, our results suggest that children younger than 2 years or with persistent asthma or lower asthma quality-of-life scores are at greater risk for ED revisits after acute ED asthma care.

Authors+Show Affiliations

Department of Pediatrics, Children's Mercy Hospital and University of Missouri Kansas City, Kansas City, MO 64108, USA. cwalshkelly@mh.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18645538

Citation

Walsh-Kelly, Christine M., et al. "Emergency Department Revisits for Pediatric Acute Asthma Exacerbations: Association of Factors Identified in an Emergency Department Asthma Tracking System." Pediatric Emergency Care, vol. 24, no. 8, 2008, pp. 505-10.
Walsh-Kelly CM, Kelly KJ, Drendel AL, et al. Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system. Pediatr Emerg Care. 2008;24(8):505-10.
Walsh-Kelly, C. M., Kelly, K. J., Drendel, A. L., Grabowski, L., & Kuhn, E. M. (2008). Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system. Pediatric Emergency Care, 24(8), 505-10. https://doi.org/10.1097/PEC.0b013e318180fdcb
Walsh-Kelly CM, et al. Emergency Department Revisits for Pediatric Acute Asthma Exacerbations: Association of Factors Identified in an Emergency Department Asthma Tracking System. Pediatr Emerg Care. 2008;24(8):505-10. PubMed PMID: 18645538.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system. AU - Walsh-Kelly,Christine M, AU - Kelly,Kevin J, AU - Drendel,Amy L, AU - Grabowski,Laura, AU - Kuhn,Evelyn M, PY - 2008/7/23/pubmed PY - 2008/10/4/medline PY - 2008/7/23/entrez SP - 505 EP - 10 JF - Pediatric emergency care JO - Pediatr Emerg Care VL - 24 IS - 8 N2 - OBJECTIVE: To identify clinical variables associated with a greater likelihood of emergency department (ED) revisit for acute asthma within 7 days after an initial ED visit for acute asthma exacerbation. METHODS: Cross-sectional study of subjects from a prospectively enrolled cohort of children aged 0 to 18 years with physician-diagnosed asthma in the ED Allies Tracking System. Demographics and data on quality of life, health care utilization, environmental factors, chronic asthma severity, and ED management were collected. Emergency department revisits for acute asthma within 7 days of a prior visit resulting in discharge were compared with those without a revisit, using chi2 and t tests and logistic regression. RESULTS: Four thousand two hundred twenty-eight ED asthma visits were enrolled; 3276 visits resulted in discharge. Persistent asthma was identified in 66% of visits. Emergency department revisits within 7 days of a prior visit occurred following 133 (4.1%) visits. There were no significant differences in environmental factors or ED management between visits with and without an ED revisit. In univariate analysis factors associated with a greater revisit likelihood included age younger than 2 years, black race or Hispanic ethnicity, persistent asthma, public insurance, lower quality of life, and greater health care utilization in the prior 12 months. Variables independently significant (P < 0.05) in logistic regression were chronic asthma severity classified as persistent, age younger than 2 years, and lower asthma quality of life. CONCLUSIONS: Although our design precludes drawing causal inference, our results suggest that children younger than 2 years or with persistent asthma or lower asthma quality-of-life scores are at greater risk for ED revisits after acute ED asthma care. SN - 1535-1815 UR - https://www.unboundmedicine.com/medline/citation/18645538/Emergency_department_revisits_for_pediatric_acute_asthma_exacerbations:_association_of_factors_identified_in_an_emergency_department_asthma_tracking_system_ DB - PRIME DP - Unbound Medicine ER -