Student Universite de Montreal Faculty of Medicine Montreal, Quebec, Canada
Background: Asthma is a leading cause of emergency department (ED) visits and hospitalizations with about 15% of hospital admissions. The recurrence of ED visits due to uncontrolled asthma symptoms negatively affects children’s quality of life. Despite advancements in pediatric asthma management, the return visit rate for an acute asthma exacerbation varies from 4% to 25% within 2 weeks following the initial ED visit. Very few studies have identified factors associated with bounce-back visits in pediatric ED. Objective: This study aims to identify factors associated with return visits following pediatric ED discharge for asthma exacerbation. Design/Methods: A retrospective cohort study was conducted, involving children aged 18 months to 18 years, who were discharged from a tertiary care pediatric hospital’s ED for acute asthma exacerbations between April 2022 and March 2023. The primary outcome was a return visit to the same ED for asthma exacerbation within seven days following the initial visit. The potentials explored predictor variables were demographics information’s, disease characteristics, asthma related treatment, ED crowding factors and health care provider attributes. With Smeden et al. tool, it was estimated that evaluating a random sample of 246 children (expected return rate of 8%) would allow the evaluation of 10 potential predictors. A consecutive sample of 270 patients was obtained. Data analysis is currently ongoing, with an anticipated completion date set for December 1st. First, a univariate analysis, employing odds ratios, will be performed to understand predictor variable associations with the primary outcome. Subsequently, a multivariable logistic regression, utilizing a forward stepwise technique, will be carried out based on magnitude changes in odds ratios and association strengths. This study aims to identify factors associated with return visits after ED discharge for asthma exacerbation in pediatric patients. Identifying these elements could enhance pediatric asthma management in emergency settings.
