Validation of the Hospital Asthma Severity Score (HASS) in children ages 2–18 years old

Abecassis, Leah; Gaffin, Jonathan M.; Forbes, Peter; Schenkel, Sara; McBride, Sarah; DeGrazia, Michele

doi:10.1080/02770903.2020.1852414

Cited by 6 publications

(11 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The HASS score was developed by a multidisciplinary inpatient asthma committee after a review of previously described pediatric asthma severity scores (PASS) and their respective clinical applications 4–11,13 . Several of these severity scores have been validated against an objective pulmonary function measurement such as spirometry or peak expiratory flow rate and the majority have demonstrated good interrater reliability among clinical providers 4,8,10,11,13 .…”

Section: Discussionmentioning

confidence: 99%

“…The HASS was subsequently automated at this study's institution with a self-populated total score calculation and embedded within the electronic patient flowsheet, making charting and HASS trending easier among clinical staff at the time of care delivery. A hospital-wide clinical practice guideline for asthma management was subsequently developed using HASS ranges as a guide for categorizing disease severity (mild <7, moderate [7][8][9], and severe [10][11][12][13][14][15]) and has been a valuable reference for clinical staff on all units to inform timely treatment escalation and de-escalation.…”

Section: Discussionmentioning

confidence: 99%

“…12,14 The PRAM (range 0-12) is an assessment of scalene retractions, suprasternal retractions, wheezing, air entry, and oxygen saturation that has shown interrater and intrarater agreement with the HASS. 9 The MPIS includes assessment of oxygen saturation, accessory muscle use, inspiratory-to-expiratory flow ratio, degree of wheezing, heart rate, and respiratory rate. 15 Another scoring system was developed by Qureshi et al 16 to evaluate the efficacy of several acute asthma therapies in ED.…”

Section: T a B L E 1 Patient Demographic And Clinical Characteristicsmentioning

confidence: 99%

Section: T a B L E 1 Patient Demographic And Clinical Characteristicsmentioning

confidence: 99%

“…Several asthma severity scores have been trialed in the past for pediatric asthma exacerbations with variable limitations. [4][5][6][7][8][9][10][11][12] At the time of hospital-wide asthma severity score (HASS) development, these asthma scores were primarily used for initial respiratory evaluation among children presenting to the emergency room to predict a need for hospitalization. [4][5][6][7][8]13 In addition, components of asthma scoring systems can be based upon subjective assessments of respiratory distress which has the potential to impact score reliability when used among different care providers.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

A pediatric hospital‐wide asthma severity score: Reliability and effectiveness

McBride

McCarty

Wong

et al. 2022

Pediatric Pulmonology

View full text Add to dashboard Cite

Background: Asthma is a leading cause of pediatric hospitalization in the United States. Children hospitalized with asthma are often managed in different care settings during hospitalization, posing challenges to accurate communication among care providers about illness severity. Our objective was to study the feasibility, reliability, and safety of a new pediatric hospital-wide asthma severity score (HASS) across different care units within a single tertiary-care pediatric center.Methods: 150 patients between the ages of 2 and 18 years hospitalized with a principal diagnosis of status asthmaticus were included in this study. Study patients were followed from the time of initial triage in the emergency department until the time of medical readiness for discharge. Rates of medical errors, early transfers to a higher level of care and medically indicated hospital length of stay (LOS) were compared between 75 patients before and 75 patients after widespread implementation of the HASS using retrospective chart review and anonymous staff reporting. Interrater reliability was determined by collecting independent HASS scores from blinded staff members after tandem or simultaneous patient assessment.Results: Interrater reliability among untrained staff members using the HASS was high. Hospital LOS, rates of adverse events, medical errors, and early transfer to a higher level of care were not significantly different before and after widespread HASS implementation. Conclusion:The HASS is a reliable asthma severity tool that can be used throughout hospitalization and among multiple clinical providers to trend clinical progress and optimize communication, particularly during times of care handoffs.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: T a B L E 1 Patient Demographic And Clinical Characteristicsmentioning

confidence: 99%

Section: T a B L E 1 Patient Demographic And Clinical Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A pediatric hospital‐wide asthma severity score: Reliability and effectiveness

McBride

McCarty

Wong

et al. 2022

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

Lung Ultrasound Findings in Children With Asthma Exacerbations

Hoffmann,

Neuman,

et al. 2024

J of Ultrasound Medicine

View full text Add to dashboard Cite

ObjectiveWe sought to assess whether the presence and extent of lung ultrasound (LUS) findings were associated with asthma exacerbation severity in children.MethodsWe enrolled a convenience sample of patients aged 5–18 years presenting with acute asthma exacerbation to a tertiary care pediatric emergency department. Severity of an asthma exacerbation (mild, moderate, severe) was assessed within 1 hour of the LUS using the Hospital Asthma Severity Score, a validated asthma assessment tool. LUS was performed by trained pediatric emergency providers. The presence of LUS findings (B‐lines, consolidations, pleural effusion, and pleural line abnormalities) was assessed using a standardized criterion based on consensus guidelines.ResultsA total of 111 patients with a median age of 8 years (interquartile range 6–12) were enrolled. LUS was positive in 57% of patients. Pleural line abnormalities were observed in 34%, B‐lines in 29%, consolidations <1 cm in 24%, and consolidations ≥1 cm in 7%. Patients with moderate and severe asthma exacerbations were more likely to have any B‐lines (31% and 43%, respectively) than patients with mild exacerbations (12%; P = .021); however, the presence of ≥3 B‐lines or confluent B‐lines did not differ across severity groups. The presence of other findings did not differ based on asthma severity.ConclusionsLUS findings are observed in a substantial portion of children presenting with asthma exacerbations. B‐lines were the only LUS finding significantly associated with asthma severity, while lung consolidations <1 cm and >1 cm were not correlated with severity. These findings provide valuable information for the diagnostic use of LUS in pediatric patients with asthma exacerbation.

show abstract