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Asthma exacerbations: risk factors for hospital readmissions

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Abstract

Objective

The aim of our study is to analyse hospital readmissions due to asthma, as well as the factors associated with their increase.

Study design

We carried out a retrospective study including all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010.

Methods

The data were gathered by two members of the research team, by reviewing the clinical records. The first hospital admission of each patient was included for this study. An early readmission (ER) was defined as that which occurred in the following 15 days after hospital discharge and late readmission (LR) to that occurring from 16 days after discharge.

Results

This study included 2166 hospital admissions and 1316 patients, with a mean age of 62.6 years. Of the 1316 patients analysed, 36 (2.7%) had one ER and 313 (23.8%) one LR. The only factor independently associated with a higher probability of an ER was poor lung function. A higher probability of LR was associated with a greater severity of the asthma (OR: 17.8, for severe asthma versus intermittent asthma), to have had any hospital admission in the previous year (OR: 3.5) and the use of a combination of ICS-LABA as maintenance treatment.

Conclusions

About 25% of the patients in our area admitted to hospital due to asthma exacerbation had repeat episodes of hospitalisation.

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Author information

Authors and Affiliations

  1. Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain

    F.-J. Gonzalez-Barcala & L. Valdes-Cuadrado

  2. Departamento de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, Spain

    F.-J. Gonzalez-Barcala

  3. CIBER Enfermedades Respiratorias (CibeRes), Barcelona, Spain

    F.-J. Gonzalez-Barcala & X. Muñoz

  4. Servicio de Neumología-Hospital de El Ferrol, Ferrol, Spain

    U. Calvo-Alvarez

  5. Servicio de Urgencias-Hospital do Salnes, Pontevedra, Spain

    M.-T. Garcia-Sanz

  6. Servicio de Neumología-Hospital Clinico, Universitario de Santiago de Compostela, Santiago de Compostela, Spain

    N. Garcia-Couceiro

  7. Servicio de Salud Laboral-Hospital Clinico, Universitario de Santiago de Compostela, Santiago de Compostela, Spain

    P. Martin-Lancharro

  8. Servicio de Medicina Interna-Hospital Clinico, Universitario de Santiago de Compostela, Santiago de Compostela, Spain

    A. Pose

  9. Departamento de Radiología, Universidad de Santiago de Compostela, Santiago de Compostela, Spain

    J.-M. Carreira

  10. Servicio de Pediatria-Hospital Clinico, Universitario de Santiago de Compostela, Santiago de Compostela, Spain

    J.-D. Moure-Gonzalez

  11. Servicio de Neumología-Hospital, Universitario Vall d’Hebron-Barcelona, Barcelona, Spain

    X. Muñoz

  12. Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, Spain

    X. Muñoz

Authors
  1. F.-J. Gonzalez-Barcala
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  2. U. Calvo-Alvarez
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  3. M.-T. Garcia-Sanz
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  4. N. Garcia-Couceiro
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  5. P. Martin-Lancharro
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  6. A. Pose
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  7. J.-M. Carreira
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  8. J.-D. Moure-Gonzalez
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  9. L. Valdes-Cuadrado
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  10. X. Muñoz
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Corresponding author

Correspondence to F.-J. Gonzalez-Barcala.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

SUMMARY

We assessed the rate of asthma hospital readmissions and the factors related to higher incidence of this event.

TAKE-AWAY POINTS

One of the most important aspects of asthma hospital admissions is the group of patients with hospital readmissions, which also are a good indicator of the quality of the health care.

In our country:

• The rate of early readmissions (ER), less than 3%, does not seem high.

• The only factor associated with a higher probability of ER was lung function

• The factors associated with late readmissions were greater baseline asthma severity, history of any hospital admission in the previous year and the use of a combination of inhaled corticosteroid (ICS)/long-acting beta2 agonist (LABA) as baseline treatment.

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Gonzalez-Barcala, FJ., Calvo-Alvarez, U., Garcia-Sanz, MT. et al. Asthma exacerbations: risk factors for hospital readmissions. Ir J Med Sci 187, 155–161 (2018). https://doi.org/10.1007/s11845-017-1633-9

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  • DOI: https://doi.org/10.1007/s11845-017-1633-9

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