ABSTRACT
This study was undertaken to reveal he rate and predictors of asthma related readmissions at Alexandria University Children's Hospital. Children attending the emergency department with an acute episode of asthma between October the 1[st], 2004 and March the 31[st], 2005 were enrolled in this study. They were subjected to a detailed medical history and clinical evaluation to obtain relevant information. Data were subjected to a detailed medical history and clinical evaluation to obtain relevant information. Data were analyzed using the univariate and multivariate and multivariate logistic regressions analyses. The study included 304 asthmatic children between 2 and 12 years of age. In 80% of them, the diagnosis was made before the age of 2 years. Parents of 51.0% of the children perceived the child's asthma as severe, 38.2% viewed that the child's activity is variably affected and 23.6% expressed that the control of asthma is either unsatisfactory or bad. Children who felt in the band of moderate to severe asthma accounted for 54.3% of the sample; in the preceding four weeks, 32.6% experienced asthma symptoms more than twice weekly and 36.8% had night symptoms more than twice per month. Only 18.1% were receiving prophylactic therapy and 55.3% attended for periodic follow up. In a life time, 60% were hospitalized and 36.8% were readmitted within a year of a previous admission. Readmission because of bronchial asthma was independently predicted by the frequency of asthma symptoms and night symptoms, disease severity score and unsatisfactory or bad control of asthma. it is also predicted by life time hospitalization, lack of periodic follow up and non-use of prophylactic therapy. This is in addition to presence of a smoker in the household, bad ventilation and high sleeping index. These children constitute a group of asthmatic with moderate to severe disease and high rates of readmission but still readmission could be prevented. Parents and children should avoid the identified precipitating factors of an attack, ensure appropriate ventilation and strictly prohibit smoking in the household. Physicians and parents should work together to develop a better understanding of the child's condition and to set an asthma management plan including crisis intervention. Adherence to preventive therapy and periodic follow up should be the rule. Educational sessions should be considered for parents to develop skills and competencies in controlling their children's asthma. Further research is needed to evaluate the quality of care provided to asthmatic children at the emergency department and inpatient