Predictors of short term readmission of asthmetic children

ABSTRACT

Bronchial asthma admission rate has increased dramatically all over the world. Part of this increase in hospital admissions is due to patients readmission. Determining what risk factors are associated with short term hospital readmission of pediatric patients with asthma within two months of the last hospital admission.A retrospective case-control study using registration books of both admissions and discharges to identify patients groups. All hospital records were reviewed for patients admitted from August 1998 through December 2002 at Assir Central Hospital, southwestern of Saudi Arabia. Patients who were admitted at this period of study and they were readmitted to the hospital within two months constituted the study group [n=28] and those patients who were admitted within the same period but not readmitted within two months constituted the control group [n=45]. Demographic variables, route of admission, patient previous medical history, clinical assessment, hospital treatment as well as discharge treatment were extracted from medical records twenty eight patients were readmitted within two months of the discharge from hospital [17 boys and 11 girls] seventy percent of these were below four years of age. Significant predictors of readmission were; prior history of asthma admission [adjusted OR 1.81[1.20-2.73], NICU graduate [adjusted OR 4.44 [1.67-6.34], chronic lung disease [adjusted OR 3.06, 95% Cl 2.01-4.95], tracheosphageal fistula [Adjusted OR 3.19, 95% Cl 1.08-8.74], recurrent aspiration [adjusted OR 3.14, 95% Cl 1.90-4.27], duration of asthma symptoms more than four days [adjusted OR 0.23, Cl 0.21-0.42], moderate to severe clinical assessment [adjusted OR 1.67 95% Cl 1.15-3.04], intensive care admission [adjusted OR 2.96, 95% Cl 1.09-8.63], intravenous steroids [adjusted OR 2.21,95% Cl 1.36-4.67], and chest x-ray findings [adjusted OR 0.39, 95% Cl0.20-0.64]. Previous NICU admission, bronchopulmonary dyspalsia, and history of previous asthma admissions, tracheosophageal fistula, recurrent aspirations, intensive care admission, intubation and intravenous steroids were significant predictors of asthma short readmission