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Acute asthma ICU admissions often occur in low-, medium-volume hospitals

Researchers have discovered a relationship between hospital volume and lengths of stay in an intensive care unit for children with acute asthma, according to recently published data.

“The prevalence of asthma in children has increased in recent years and with it there has been an increase in the number of patients with asthma requiring admission to a pediatric intensive care unit (PICU),” the researchers wrote. “Aggressive medical therapy, including endotracheal intubation and need for positive pressure ventilation, may be required in these children. However, there is wide variation of the care of these patients across various centers that can be attributed to local and physician practice patterns.”

Punkaj Gupta, MBBS, of the University of Arkansas for Medical Sciences, and colleagues evaluated the association of center volume with the odds of receiving positive pressure ventilation and length of ICU stay among 15,083 patients (median age, 81 months; median weight, 24.2 kg; 60% male) aged 2 to 18 years from 103 pediatric ICUs with acute asthma.

Data indicated that 752 (5%) patients received conventional mechanical ventilation; 964 (6%) received noninvasive ventilation.

The ICU lengths of stay appeared longer in all patients with acute asthma in low-volume centers compared with medium- and high-volume centers after adjustments for confounders.

“For example, patients with acute asthma in the low- to medium-volume centers were estimated to be 1.33 times (95% CI, 1.01-1.75) more likely to be discharged than those patients in the low-volume centers,” the researchers wrote.

They concluded that further analyses are needed to evaluate this relationship.

Disclosure: See the study for a full list of relevant financial disclosures.