Factors affecting readmission for acute asthmatic attacks in children.

Background: Readmission following acute asthmatic attack has an impact on children's quality of life and the cost of hospitalization. The objective of this study was to define the risk factors associated with readmission following acute asthmatic attacks in children.

Methods: This is a retrospective case-control study in children who were admitted because of acute asthmatic attacks at the Department of Pediatrics, Siriraj Hospital, Mahidol University, Bangkok, Thailand. The admissions were classified into 2 groups, admission and readmission within one-month to one-year after the first admission. The medical records were reviewed and the factors that might affect readmission were evaluated.

Results: Seventy six children, 49 males and 27 females, were included. There were 56 children who were admitted only once and 20 children who were readmitted. The 1-year readmission rate for children with asthma was 26.3 %. The risk factors which made readmission more likely were a parental history of allergic disease (Odd Ratio, OR, = 3.17; 95% CI 1.10-9.10), a history of Intensive Care Unit (ICU) admission (OR 29.62; 95% CI 3.35-262.18), methylprednisolone usage during the 1st admission (OR 8.33; 95% CI 2.46-28.19) and the level of asthma control. Increased risk of readmission was found in partly controlled asthma (OR 4.83; 95% CI 1.24-18.88) and uncontrolled asthma (OR 29; 95% CI 2.25-373.77). The factor that decreased the chances of readmission was a history of influenza vaccination (OR 0.24; 95% CI 0.16-0.36).

Conclusion: A history of ICU admission at the first admission and the level of asthma control (partly controlled and uncontrolled according to Global of Initiative for Asthma guideline) increased the chances of readmission while influenza vaccination reduced the chances of readmission.