Female sex is associated with increased risk of early readmission with asthma in Staffordshire children

Abstract

Background: Asthma is the commonest medical reason for a child to be admitted to hospital in the UK. c.15% are readmitted within 3 months.

Aim: We undertook a retrospective case-control study to determine the predictors of readmission.

Methods: We retrieved the medical notes of 35 children readmitted within 90 days following an admission for asthma (cases). We randomly selected 35 children with asthma who were not readmitted (controls). We recorded: age, gender, ethnicity, history of eczema, hayfever or rhinitis, parental smoking status, pet ownership, number of siblings, previous admissions, postcode, age-corrected respiratory rate, heart rate, presence of recession, and oxygen saturations at admission. We also recorded length of stay, use of nebulisers, antibiotics and use of a personal asthma action plan. We used forwards stepwise logistic regression (p<0.1) to determine any factors associated with readmission by 30 (early) and 90 days (late).

Results: At 30 days only female gender (p=0.002) and personal history of eczema (p=0.063) were associated with readmission. One third of girls were readmitted by 30 days (n=8), compared to less than 5% of boys (2/45) (p=0.001). By 90 days, the effect of gender had become insignificant but history of previous admission (p=0.018) and age (p=0.073) were associated with readmission. Even following correction for age, the initial vital signs and apparent severity were not predictive of readmission.

Conclusion: This small study demonstrates that female sex is associated with increased risk of early readmission with asthma. Vital signs on admission, provision of education or an asthma plan was not associated with risk of early or late readmission.