Characteristics of Asthma Patients Admitted to an Intermediate Respiratory Care Unit

Núñez, Belén; Fiorentino, Federico; Kersul, Ana; Belda, Sonia; García, Stella Maris; Gutiérrez, Catalina; Sala, Ernest; Cosío, Borja G.

doi:10.1016/j.arbr.2013.02.005

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…More recent literature describes successful care for adult patients with specific diseases in IMCUs, including severe asthma and sepsis. 15,16 Interestingly, we found IMCUs in only 17% of responding institutions, which is significantly lower than the 33% and 55% noted in the literature previously. 1,2 This is possibly a result of our query, which asked for triage practices for patients presenting in the emergency department, and thus would not capture any IMCUs that act exclusively as step-down units to ICUs.…”

Section: Discussioncontrasting

confidence: 51%

Triage of Intermediate-Care Patients in Pediatric Hospitals

Russ

Agus

2015

Hospital Pediatrics

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BACKGROUND: Hospitalized children have a wide range of acuity and risk of decompensation. The objective of this study was to determine where pediatric patients are triaged when they present to pediatric hospitals needing intense monitoring and nursing care, but do not require invasive monitoring or technology. METHODS: We completed a telephone survey of pediatric hospitals in the United States with at least 2 non-neonatal pediatric wards and at least 50 acute inpatient beds. The survey consisted of a brief scripted portrayal of 6 hypothetical patients who may be admitted to a hospital's general floor, ICU, or an intermediate care unit (IMCU). The scenarios included severe asthma, bronchiolitis, croup, diabetic ketoacidosis, and patients dependent on home ventilation via noninvasive interface or tracheostomy. The hospital bed coordinator or emergency department charge nurse was asked where each hypothetical patient would be admitted in their hospital. RESULTS: A total192 hospitals met inclusion criteria and 164 hospitals (85%) responded. For all of the scenarios, most of the institutions triaged them to the PICU. Twenty-eight (17%) of the responding institutions triaged at least 1 of the patient scenarios to an IMCU. The presence of an IMCU decreased triage to the ICU for all scenarios when comparing hospitals with and without an IMCU (P < .001). CONCLUSIONS: Inpatient triage practices among pediatric hospitals vary widely for patients who require intense nursing or frequent monitoring due to specific acute illnesses or respiratory technologies. Institutions that have an IMCU available are less likely to send these patients to the ICU.

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Section: Discussioncontrasting

confidence: 51%

Triage of Intermediate-Care Patients in Pediatric Hospitals

Russ

Agus

2015

Hospital Pediatrics

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“…6 Currently, the question of safety of NIV use in exacerbations of asthma remains a controversial and a highly debated topic. We need to reinforce the influence of epidemiological factors on disease prevalence and acknowledge that the asthma population is increasing in size.…”

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confidence: 99%

“…If so, were any associated reductions in the cost of healthcare provision achieved? 6,7 Thirdly, the authors do not offer any information on well-known determinants of the success of NIV such as seasonal variations and patterns of exacerbations, the incidence of obesity (which is a major factor in the invasive mechanical ventilation (IMV) group), 3 a previous history of ICU admissions and general patient demographics.…”

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confidence: 99%

Should safety of non‐invasive mechanical ventilation in asthma be considered from the evidence or real practice perspective?

Esquinas

2015

Respirology

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Trends in hospital admissions among children with asthma in Spain (2011–2020)

et al. 2023

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The purpose of this study is to describe and assess changes in incidence, clinical conditions, use of mechanical ventilation, length of hospital stay (LOHS), and in-hospital mortality (IHM) among children hospitalized with asthma in Spain from 2011 to 2020. We analyzed children aged 0 to 15 years hospitalized with an ICD code for asthma included in the Spanish National Hospital Discharge Database (SNHDD). The analysis was conducted for asthma as the primary diagnosis and with asthma in any diagnosis position. Joinpoint regression was used to assess time trends in incidence. We included a total of 85,664 children hospitalized with asthma; of these, 46,727 (54.55%) had asthma coded as the primary diagnosis. The number of boys was higher than the number of girls, irrespective of age group or diagnostic position. The frequency of asthma as primary diagnosis decreased from 55.7% in 2011 to 43.96% in 2020 (p < 0.001). The incidence of hospitalizations because of asthma decreased significantly from 2011 to 2020, with a faster decrease from 2018 onwards. Over time, the proportion of older children increased. In the year 2020, only 55 children had codes for asthma and COVID-19 in their discharge report, and this infection had no effect on hospitalizations this year. A significant increase in the use of non-invasive ventilation (NIV) was observed over time. Irrespective of the diagnostic position, LOHS and IHM remained stable over time, with the IHM under 0.1%. Conclusion: Our results show a decrease in the incidence of hospital admissions with asthma either as the primary diagnosis or in any position. The age of children hospitalized seems to be increasing as the use of NIV. Better management of the disease from primary care and the emergency department as is the use of NIV could explain the reduction in incidence. What is Known: • Asthma is the most common chronic respiratory in childhood in high income countries. • The incidence of hospital admissions with asthma and associated factors is one of the best sources of information on morbidity trends and prognosis. What is New: • The incidence of hospital admissions for asthma in Spain decreased in children between 2011 and 2020 with a more frequent use of non-invasive mechanical ventilation and low mortality rates. • COVID-19 did not cause an increase in admissions with asthma in the year 2020.

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Characteristics of Asthma Patients Admitted to an Intermediate Respiratory Care Unit

Cited by 5 publications

References 32 publications

Triage of Intermediate-Care Patients in Pediatric Hospitals

Triage of Intermediate-Care Patients in Pediatric Hospitals

Should safety of non‐invasive mechanical ventilation in asthma be considered from the evidence or real practice perspective?

Trends in hospital admissions among children with asthma in Spain (2011–2020)

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