PREDICTORS OF SHORT-TERM HOSPITAL READMISSIONS OF ASTHMATIC CHILDREN

Background: The admission rate for bronchial asthma has increased dramatically all over the world. Part of this increase in hospital admissions is due to patient readmission. Objective: To determine the risk factors associated with short-term hospital readmission of pediatric patients with asthma within two months of the last hospital admission. Methods and setting: A retrospective case-control study using the registration books of both admissions and discharges to identify patient groups. All hospital records of patients admitted from August 1998 through December 2002 at Aseer Central Hospital, southwestern Saudi Arabia were reviewed. Patients who were admitted during this period of study and readmitted to hospital within two months were used as the study group (n=28) and those patients admitted within the same period but not readmitted within two months constituted the control group (n=45). Demographic variables, route of admission, patient's previous medical history, clinical assessment, hospital treatment as well as discharge treatment were obtained and entered for analysis. Results: Twenty-eight patients were readmitted within two months of their discharge from hospital (17 boys and 11 girls). Seventy percent of these were less than four years of age. Significant predictors of readmission were: prior history of asthma admission (adjusted OR 2.21,95% CI 1.08-9.10), neonatal intensive care graduate (adjusted OR 4.44,95% CI 1.67-9.34), bronchopulmonary dysplasia (adjusted OR 3.06,95% CI 2.01-7.95), recurrent aspiration (adjusted OR 1.96,95% CI 1.08-4.27), duration of asthma symptoms more than five days (adjusted OR 0.15,95% CI 0.03-0.42), moderate to severe clinical assessment (adjusted OR 1.12,95% CI 1.01-2.94), positive X-ray findings (adjusted OR 0.04,95%CI 0.011-0.230), intensive care admission (adjusted OR 1.96,95%CI 1.08-4.63), mechanical ventilation (adjusted OR 0.010,95%CI 0.002-0.130), intravenous steroids (adjusted OR 0.104 ,95%CI 0.016-0.321). Conclusion: Prior neonatal intensive care unit admission, bronchopulmonary dysplasia, history of previous asthma admissions, recurrent aspirations, intensive care unit admission, intravenous steroids, positive X-ray findings and mechanical ventilation were significant predictors of asthma short-term hospital readmissions.