Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA.
Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
Int J Environ Res Public Health. 2021 Jan 9;18(2):486. doi: 10.3390/ijerph18020486.
This retrospective study examines demographic and risk factor differences between children who visited the emergency department (ED) for asthma once ("one-time") and more than once ("repeat") over an 18-month period at an academic medical center. The purpose is to contribute to the literature on ED utilization for asthma and provide a foundation for future primary research on self-management effectiveness (SME) of childhood asthma. For the first round of analysis, an 18-month retrospective chart review was conducted on 252 children (0-17 years) who visited the ED for asthma in 2019-2020, to obtain data on demographics, risk factors, and ED visits for each child. Of these, 160 (63%) were "one-time" and 92 (37%) were "repeat" ED patients. Demographic and risk factor differences between "one-time" and "repeat" ED patients were assessed using contingency table and logistic regression analyses. A second round of analysis was conducted on patients in the age-group 8-17 years to match another retrospective asthma study recently completed in the outpatient clinics at the same (study) institution. The first-round analysis indicated that except , none of the individual demographic or risk factors were statistically significant in predicting of "repeat" ED visits. More unequivocally, the second-round analysis revealed that none of the individual factors examined (including , , , , and , among others) were statistically significant in predicting "repeat" ED visits for childhood asthma. A key implication of the results therefore is that something other than the factors examined is driving "repeat" ED visits in children with asthma. In addition to contributing to the ED utilization literature, the results serve to corroborate findings from the recent outpatient study and bolster the impetus for future primary research on SME of childhood asthma.
这项回顾性研究考察了在学术医疗中心，18 个月期间因哮喘首次（“单次”）和多次（“重复”）前往急诊部（ED）就诊的儿童在人口统计学和风险因素方面的差异。其目的是为 ED 利用哮喘文献做出贡献，并为未来儿童哮喘自我管理效果（SME）的初级研究提供基础。在第一轮分析中，对 2019-2020 年期间因哮喘前往 ED 的 252 名（0-17 岁）儿童进行了为期 18 个月的回顾性图表审查，以获取每位儿童的人口统计学、风险因素和 ED 就诊数据。其中，160 名（63%）为“单次”，92 名（37%）为“重复”ED 患者。使用列联表和逻辑回归分析评估“单次”和“重复”ED 患者之间的人口统计学和风险因素差异。第二轮分析针对年龄在 8-17 岁的患者进行，以匹配同一（研究）机构门诊最近完成的另一项回顾性哮喘研究。第一轮分析表明，除了 ，没有任何单个人口统计学或风险因素在预测“重复”ED 就诊方面具有统计学意义。更明确地说，第二轮分析表明，在所检查的单个因素（包括 、、、、和 等）中，没有一个在预测儿童哮喘的“重复”ED 就诊方面具有统计学意义。因此，结果的一个关键含义是，除了检查过的因素之外，还有其他因素导致哮喘儿童的“重复”ED 就诊。除了为 ED 利用文献做出贡献外，这些结果还证实了最近门诊研究的发现，并为未来儿童哮喘 SME 的初级研究提供了动力。
