title: Predictors of repeat visits to the emergency room by asthmatic children in primary care.
abstract: BACKGROUND
  Subsets of asthmatic children, particularly in the Caribbean, burden the health system through repeated emergency room (ER) visits. We examined children to determine predictors of repeated ER visits in Trinidad.
  
  
  METHODS
  Caregivers of 300 asthmatic children in primary healthcare in Trinidad reported on perceived factors of exacerbated wheeze requiring ER services.
  
  
  RESULTS
  Prevalence of ER utilization in the past 12 months was 59.7% and 40.3% for repeated visits. Average age of wheezing onset was 2.8 (SD = 2.5) years. From the logistic regression analyses, independent predictors of repeat ER visits were mothers with a history of asthma (OR = 2.0, 95%Cl = 1.0-4.0), exposure to perfumes/odors (OR = 2.4, 95% Cl = 1.4-4.2), using inhaled corticosteroids (ICS) (OR = 2.2, 95% Cl = 1.2-4.0), and young age group (1-5 vs. 13-16 years) (OR = 2.7, 95% Cl = 1.1-6.4). More 1-5 year-olds (63.8%) and 6-12-year-olds (60.2%) wheezed in the dry and wet seasons, respectively (p = 0.04). Follow-up was poor (32.3%), and disease management did not include educational interventions.
  
  
  CONCLUSIONS
  Repeated ER use in pediatric asthma underscores a pressing need for health providers and caregivers to develop an asthma management plan noting the identified predictors to assist in reducing Trinidad's asthma burden.
authors.affiliation: Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago, West Indies.
authors.forename: Fawwaz
authors.initials: F
authors.lastname: Mohammed
authors.forename: Sarita
authors.initials: S
authors.lastname: Bootoor
authors.forename: Avidesh
authors.initials: A
authors.lastname: Panday
authors.forename: Avinash
authors.initials: A
authors.lastname: Ramdass
authors.forename: Jeanine
authors.initials: J
authors.lastname: Reemaul
authors.forename: Anu
authors.initials: A
authors.lastname: Sharma
authors.forename: Marsha
authors.initials: M
authors.lastname: Ivey
authors.forename: Lexley M
authors.initials: LM
authors.lastname: Pinto Pereira
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014300:Trinidad and Tobago / Q000453:epidemiology