PURPOSE OF THE STUDY.
To describe the subsequent course of children who are admitted to an ICU for asthma.
All children with asthma aged 2–18 years admitted to the ICU at the Royal Children's Hospital Melbourne between 1990 and 2004.
Data were collected by reviewing medical records and through telephone interviews.
A total of 410 children were identified, with a mean duration of follow-up of 10.3 ± 4.6 years. Twelve patients (1.8%) subsequently died of asthma (5% of those who required ventilation at their index admission). Risk factors for mortality were multiple ICU admissions (adjusted odds ratio [aOR]: 5.0; 95% confidence interval [CI]: 1.3–19) and mechanical ventilation (aOR: 4.5; 95% CI: 1.3–15.7). Sixty-seven percent of patients were readmitted to the hospital for asthma at least once, with 17% readmitted to the ICU. Risk factors for ICU readmission were admission for asthma in the preceding year (aOR: 4.7; 95% CI: 2.4–9.3) and mechanical ventilation (aOR: 2.4; 95% CI: 1.0–5.3).
Admission to the ICU for asthma is a predictor of hospital readmission. Those who require ventilation are at significant risk of mortality.
Although asthma mortality has declined to some extent in recent years, children continue to die of this disease. Most of these deaths are almost certainly preventable. Children who have required admission to the ICU and especially those who have required mechanical ventilation are at much higher risk and deserve close monitoring and follow-up in a specialty clinic.
- Copyright © 2012 by the American Academy of Pediatrics