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首页> 外文期刊>Pediatric emergency care >Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system.
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Emergency department revisits for pediatric acute asthma exacerbations: association of factors identified in an emergency department asthma tracking system.

机译：急诊科重新评估小儿急性哮喘发作：急诊科哮喘追踪系统中确定的因素的关联。

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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.
机译：目的：确定与急诊就诊的急性哮喘急性发作后7天内急诊科（ED）再次接受急诊哮喘相关的临床变量。方法：在ED Allies追踪系统中，对一组经过前瞻性纳入的0-18岁儿童经医生诊断为哮喘的儿童进行了横断面研究。收集有关生活质量，卫生保健利用率，环境因素，慢性哮喘严重程度和急诊管理的人口统计学和数据。急诊科在就诊前7天内对导致出院的急性哮喘进行了复查，并与未复查的进行了比较，采用了chi2和t检验以及逻辑回归。结果：招募了428例ED哮喘患者。 3276人次出院。在66％的就诊中发现了持续性哮喘。在133次（4.1％）访问之后，急诊科在上次访问的7天内进行了重新访问。在没有进行ED复查的情况下，访视之间的环境因素或ED管理没有显着差异。在单因素分析中，与重新访视的可能性更大相关的因素包括小于2岁的年龄，黑人或西班牙裔种族，持续性哮喘，公共保险，生活质量降低以及在过去12个月中医疗保健利用率更高。 Logistic回归中独立显着变量（P <0.05）为慢性哮喘严重程度，其分类为持续性，年龄小于2岁和较低的哮喘生活质量。结论：尽管我们的设计排除了因果关系的推断，但我们的结果表明，在接受急性ED哮喘治疗后，年龄小于2岁或患有持续性哮喘或哮喘生活质量评分较低的儿童发生ED的风险更高。

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