School of Biomedical Sciences, Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
School of Public Health and Epidemiology, La Trobe University, Melbourne, Victoria, Australia.
Emerg Med Australas. 2021 Dec;33(6):1027-1035. doi: 10.1111/1742-6723.13796. Epub 2021 May 15.
Patient characteristics with exacerbation of asthma accessing care in the ED who are at risk of hospital admission have not been determined in subtropical climates. The objective of the study was to investigate the spatiotemporal burden of asthma hospital admissions across Queensland (QLD) and model risk factors for asthma hospital admission following an ED visit.
Six years of routinely collected data (2012-2017) from 28 QLD public hospitals were extracted from Queensland Health's Emergency Data Collection. The dataset contained individual, episode-level ED presentations having asthma-like diagnoses, and an indicator of hospital admission, including to short-stay unit (SSU). A generalised additive model was used to examine the risk of asthma hospital admission.
Asthma hospital admissions increased from a weekly median of 79 (interquartile range [IQR] 66-99) in 2012 to 104 (IQR 81-135) in 2017. A higher incidence of asthma hospital admission was observed among males (median age 9, IQR 5-32) in childhood and females in adulthood (median age 32, IQR 11-51). Compared to the state capital Brisbane, the odds of asthma hospital admission ranged from 0.48 (95% CI 0.42-0.54) to 1.34 (95%CI 1.21-1.48) in other regions of QLD.
Asthma hospital admissions appear to be increasing in QLD, largely driven by utilisation of the SSU admissions for asthma. With large variation in both incidence and proportion admitted across different regions, routinely collected data can in part be used to understand risk factors for asthma-related hospital admission following an ED presentation and further inform public health policy development.
在亚热带气候中，尚未确定在急诊就诊时病情加重的哮喘患者的特征，这些患者有住院风险。本研究的目的是调查昆士兰州（QLD）的哮喘住院治疗的时空负担，并对急诊就诊后哮喘住院的风险因素进行建模。
从昆士兰卫生部的急诊数据采集系统中提取了 28 家 QLD 公立医院的六年常规数据（2012-2017 年）。该数据集包含了个体、发作水平的急诊就诊记录，这些记录有类似哮喘的诊断，并包括住院指标，包括短期住院部（SSU）。使用广义加性模型来检查哮喘住院的风险。
哮喘住院人数从 2012 年每周中位数 79 人（四分位距 [IQR] 66-99）增加到 2017 年的每周中位数 104 人（IQR 81-135）。在儿童时期，男性（中位数年龄 9 岁，IQR 5-32）和成年女性（中位数年龄 32 岁，IQR 11-51）的哮喘住院率更高。与首府布里斯班相比，在昆士兰州的其他地区，哮喘住院的几率从 0.48（95%CI 0.42-0.54）到 1.34（95%CI 1.21-1.48）不等。
QLD 的哮喘住院人数似乎在增加，这主要是由于 SSU 对哮喘的使用增加所致。由于不同地区的发病率和住院率差异很大，常规收集的数据在一定程度上可用于了解急诊就诊后与哮喘相关的住院风险因素，并进一步为公共卫生政策的制定提供信息。
