Ohio Pediatric Asthma Repository: Opportunities to Revise Care Practices to Decrease Time to Physiologic Readiness for Discharge.

Hospital Pediatrics
Jeffrey M SimmonsGurjit K Khurana Hershey

Abstract

Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation. Demographics, disease characteristics, and individual hospital practices were collected. The primary outcome was PRD timing (hours from admission or emergency department [ED] presentation until the first 4-hour albuterol spacing). Data for 1005 participants were available (865 ED presentations). Several nonstandard care practices were associated with time to PRD (P < .001). Continuous pulse oximetry was associated with increased time to PRD (P = .004). ED dexamethasone administration was associated with decreased time to PRD (P < .001) and less ICU admittance and intravenous steroid use (P < .0001). Earlier receipt of chest radiograph, antibiotics, and intravenous steroids was associated with shorter time to PRD (P < .05). Care practices associated with shorter time ...Continue Reading

References

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Citations

May 17, 2018·Hospital Pediatrics·Sunitha V Kaiser, Matthew D Garber
Jul 2, 2019·Annals of the American Thoracic Society·Leonard B Bacharier, Theresa W Guilbert
Jan 4, 2022·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Burton H ShenBrian Lee

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