title: Risk factors associated with 30-day asthma readmissions.
abstract: Assess factors that increase the odds of 30-day asthma readmissions to hospitals.
  
  
  
  Retrospective chart review between 1/1/2002 to 12/31/2012 of pediatric and adult patients with the primary diagnosis of asthma readmitted within 30 days after the index admission was performed. Patients were identified from billing database for asthma ICD 9 code (493.9). Inclusion criteria were: physician confirmed asthma diagnosis, one or more asthma admissions and accessible medical records.
  
  
  
  A total of 95 patients with multiple asthma readmissions were included in the final analysis. Thirty-seven patients (39%) were readmitted for asthma within 30 days and 58 patients (61%) had readmission in a 30-365-day period. Demographic characteristics were not significantly different between groups. Bivariate analysis showed that factors associated with higher likelihood of readmissions were a higher frequency of previous admissions, ED visits, inpatient hospitalizations, ICU stays, intubations, chest X-rays, history of chronic sinusitis, gastroesophageal reflux disease, anxiety, and the use of tiotropium or a long-acting beta-agonist (LABA). Multivariable analysis confirmed that prior hospital admissions and a history of GERD are the strongest predictive factors for early asthma readmissions, yet a history of environmental allergies might be a protective factor (p = 0.053).
  
  
  
  Non-allergic asthma patients with multiple prior admissions, ED visits and inpatient hospitalizations, on multiple medications with history of GERD, sinusitis, and anxiety are more likely to be readmitted within 30 days irrespective of other factors. Patients with these characteristics should be assessed for interventions in an effort to reduce early readmissions.
authors.affiliation: a Division of Pulmonary , Allergy and Critical Care, Penn State University, Hershey Medical Center , Hershey , PA , USA.
authors.forename: Larisa V
authors.initials: LV
authors.lastname: Buyantseva
authors.affiliation: b Heart of Lancaster Regional Medical Center , Lititz , PA , USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Brooks
authors.affiliation: a Division of Pulmonary , Allergy and Critical Care, Penn State University, Hershey Medical Center , Hershey , PA , USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Rossi
authors.affiliation: c Division of Biostatistics in the Department of Public Health Sciences , Penn State University , Hershey , PA , USA.
authors.forename: Erik
authors.initials: E
authors.lastname: Lehman
authors.affiliation: a Division of Pulmonary , Allergy and Critical Care, Penn State University, Hershey Medical Center , Hershey , PA , USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Craig
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists
keywords: Prevention; asthma; health outcomes; risk factors