title: Predicting future emergency department visits and hospitalizations for asthma using the Pediatric Asthma Control and Communication Instrument - Emergency Department version (PACCI-ED).
abstract: OBJECTIVE
  Emergency departments (EDs) are potential settings for interventions to improve asthma outcomes. Screening tools can identify children at risk of future morbidity. Our objective was to determine the predictive validity of the Pediatric Asthma Control and Communication Instrument - Emergency Department version (PACCI-ED) for future asthma-related ED visits and hospitalizations.
  
  
  METHODS
  This was a retrospective cohort study of 108 children 1-17 years old who visited an ED for asthma and completed the PACCI-ED. The PACCI-ED queries parents about prior 12-month ED visits, hospitalizations, steroid use, perceived asthma morbidity and burden, and asthma control (over prior 1-2 weeks). The primary outcome was subsequent ED visits and hospitalizations within 1 year of enrollment. Poisson regression was used to model PACCI-ED questions for future ED visits controlling for age and socioeconomic status.
  
  
  RESULTS
  Reported ED visits predicted future ED visits (adjusted incidence rate ratio (aIRR) 3.1, 95% confidence interval (CI): 1.3-7.2) but not future hospitalizations. Reported hospitalizations predicted future ED visits (aIRR 3.3; 95% CI 1.7-6.3) and hospitalizations (aIRR 6.4; 95% CI 2.3-17.6). The remaining PACCI-ED questions did not predict future ED visits or hospitalizations.
  
  
  CONCLUSIONS
  The PACCI-ED risk domain was the only domain that predicted future asthma ED visits and hospitalizations. Questions about previous ED visits and hospitalizations are the most effective questions when screening children with asthma in EDs for the risk of future health-care use.
authors.affiliation: a W. Alpert Medical School of Brown University , Providence , RI , USA .
authors.forename: Dominic J
authors.initials: DJ
authors.lastname: Wu
authors.affiliation: b Lifespan Hospitals , Providence , RI , USA .
authors.forename: Evelyn
authors.initials: E
authors.lastname: Hipolito
authors.affiliation: c Johns Hopkins University , Baltimore , MD , USA .
authors.forename: Andrew
authors.initials: A
authors.lastname: Bilderback
authors.affiliation: d University of California Los Angeles , Los Angeles , CA , USA and.
authors.forename: Sande O
authors.initials: SO
authors.lastname: Okelo
authors.affiliation: e Rhode Island Hospital and Brown University , Providence , RI , USA.
authors.forename: Aris
authors.initials: A
authors.lastname: Garro
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005544:Forecasting; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Child; emergency medicine; risk; survey; validation