title: Potential predictors of relapse after treatment of asthma exacerbations in children.
abstract: BACKGROUND
  Knowledge of factors that affect relapse will allow close monitoring of patients at risk, resulting in a decreased rate of readmission to the emergency department.
  
  
  OBJECTIVE
  To determine risk factors associated with relapse within 7 days after treatment of asthma exacerbations in children.
  
  
  METHODS
  This was a multicenter, prospective study of children with asthma attacks. Patients between the ages of 6 months and 17 years who met the criteria between June 2009 and September 2012 were considered.
  
  
  RESULTS
  The study included 1177 patients (775 males [65.8%]) with a mean (SD) age of 70.72 (48.24) months. Of them, 199 (16.9%) had a relapse within 1 week after being discharged from the hospital. Factors independently associated with relapse identified by a logistic regression model for the 1,177 study visits were having taken a short-acting inhaled β2-agonist within 6 hours before admission (odds ratio [OR], 2.43; 95% confidence interval [CI], 1.728-3.426; P = .001), presence of retraction on physical examination (OR, 1.76; 95% CI, 1.123-2.774; P = .01), no prescription for high-dose inhaled steroids on release (OR, 2.02; 95% CI, 1.370-3.002; P < .001), and not being given a written instructional plan (OR, 1.55; 95% CI, 1.080-2.226; P = .02).
  
  
  CONCLUSIONS
  Whereas having taken short-acting β2-agonists within 6 hours before admission and the presence of retractions on physical examination increased the risk of relapse after treatment of the acute attack, being given high-dose inhaled steroids and a written instructional plan when being sent home reduced the risk.
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey. Electronic address: erdemtopal44@gmail.com.
authors.forename: Erdem
authors.initials: E
authors.lastname: Topal
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ozge Altug
authors.initials: OA
authors.lastname: Gücenmez
authors.affiliation: Department of Pediatric Allergy and Asthma, Dıskapı Education and Research Hospital, Ankara, Turkey.
authors.forename: Koray
authors.initials: K
authors.lastname: Harmancı
authors.affiliation: Department of Pediatric Allergy and Asthma, Gülhane Military Medical Academy and Medical School, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arga
authors.affiliation: Department of Pediatric Emergency, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Oksan
authors.initials: O
authors.lastname: Derinoz
authors.affiliation: Department of Pediatric Allergy and Asthma, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ipek
authors.initials: I
authors.lastname: Turktas
mesh_terms: D000293:Adolescent; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010353:Patient Education as Topic; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists