The prediction of hospital admission in children with acute asthma.
OBJECTIVE
To determine whether a single assessment of children at the time of presentation to the emergency department would discriminate accurately between those requiring admission and those who could be managed at home and to examine the appropriateness of these decisions.


METHODS
Fifty-three children were assessed using a table recommended by Australian and New Zealand respiratory paediatricians, which categorizes children as probably being able to manage at home (group 1), may need admission to hospital (group 2) and certainly need admission to hospital (group 3) on the basis of oximetry, presence of wheeze and pulsus paradoxus.


RESULTS
Nine out of 11 children assigned to group 1 were managed at home and 15/17 who were predicted to require admission were admitted. No individual component of the assessment dominated the decision made. Of the 25 children allocated to group 2, 18 were admitted.


CONCLUSIONS
The method employed was highly predictive of outcome for half of the children who presented with asthma. However, 25/53 (47%) were assigned by the table to a recommendation for further assessment; this limits its usefulness.
Twaddell
S H
SH
University of Newcastle, John Hunter Hospital, New South Wales, Australia.
Henry
R L
RL
Francis
J L
JL
Gibson
P G
PG
D000208:Acute Disease; D001249:Asthma / Q000628:therapy*; D001315:Australia; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009520:New Zealand; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests