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American College of Allergy, Asthma & Immunology Annual Scientific Meeting
November 06, 2015
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One ED visit increases risk for return visits in children with asthma

SAN ANTONIO — The likelihood of future ED visits for children presenting with asthma increased exponentially with each additional return visit, according to data presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.

“Our study of asthmatic children found that the number of historical asthma-related acute care visits was predictive of future asthma-related acute care visits,” Jill Hanson, MD, of the Allergy and Immunology Fellowship Program at the Children’s Mercy Hospital, Kansas City, Missouri, told Infectious Diseases in Children. “A significant increase in probability of a future visit was observed with each additional historical visit, supporting our model’s ability to effectively risk-stratify patients based solely upon past health care utilization.”

Jill Hanson

The researchers reviewed 28,047 patient records from outpatient visits during a 3-year period. Acute care visits for the 12 months before and after outpatient visits were recorded and used to determine the odds of a future acute care visit.

Approximately 75% of patients presenting to an outpatient clinic with asthma had no history of an acute care ED visit. The probability of a future acute care visit increased by 30% with a history of one previous acute care visit and increased to 87% with a history of five or more acute care visits. Patients with no history of an acute care ED visit had significantly lower odds of a future visit, compared with patients with at least one visit (OR = 3.6; 95% CI, 3.14-4.12). The OR increased with every additional acute care visit, reaching an OR of 58.71 (95% CI, 24.34-141.61) with at least five acute care visits.

“This [data] will provide clinicians with a simple and practical tool for quickly identifying patients at high risk for future asthma-related acute care visits,” Hanson said. – by David Costill

Reference:
Hanson J, et al. Abstract 20. Presented at: American College of Allergy, Asthma and Immunology Annual Scientific Meeting; Nov. 5-9, 2015; San Antonio.

Disclosure: The researchers report no relevant financial disclosures.