Risk factors for multiple hospital admissions among children and adolescents with asthma.
OBJECTIVE
To determine the influence that hospital admission of suckling infants with asthma has on their risk for future admissions for the same cause.


METHODS
A retrospective study was conducted, in which the charts of 202 patients, all less than fifteen years of age, were evaluated. All of the patients had been treated as outpatients in a pediatric pulmonology clinic and had been admitted to the hospital on one or more occasions. A multivariate analysis was conducted in order to evaluate the risk factors associated with multiple hospitalizations.


RESULTS
Virtually all of the patients evaluated were hospitalized a second time within 18 months of the first hospitalization. Among the patients first hospitalized at = 12 months of age, the second admission occurred sooner than did that recorded for those first hospitalized at > 12 months of age (p = 0.001). The risk factors found to be associated with multiple hospital admissions were as follows: age at first admission = 12 months (odds ratio: 2.55; 95% confidence interval: 1.18-5.48); age at first admission between 13 and 24 months (odds ratio: 3.54; 95% confidence interval: 1.31-9.63); and severity of asthma symptoms (odds ratio: 3.86; 95% confidence interval: 2.02-7.40).


CONCLUSIONS
After the first hospitalization, children with asthma should be closely monitored, since the risk of subsequent admissions is elevated in the first months following discharge, especially among those of less than two years of age. Health care facilities should be organized to confront this problem appropriately and should dispense prophylactic medication more freely.
Lasmar
Laura Maria de Lima Belizario Facury
LM
Pediatrics Department, Universidade Federal de Minas Gerais, School of Medicine, Belo Horizonte, Brazil.
Camargos
Paulo Augusto Moreira
PA
Goulart
Eugênio Marcos Andrade
EM
Sakurai
Emília
E
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors