TY - JOUR
T1 - Trends in admissions for pediatric status asthmaticus in New Jersey over a 15-year period
AU - Hartman, Mary E.
AU - Linde-Zwirble, Walter T.
AU - Angus, Derek C.
AU - Watson, R. Scott
PY - 2010/10
Y1 - 2010/10
N2 - OBJECTIVE: Status asthmaticus accounts for a large portion of the morbidity and mortality associated with asthma, but we know little about its epidemiology. We describe here the hospitalization characteristics of children with status asthmaticus, how they changed over time, and how they differed between hospitals with and without PICUs. PATIENTS AND METHODS: We used administrative data from New Jersey that included all hospitalizations in the state from 1992, 1995, and 1999-2006. We identified children with status asthmaticus by using International Classification of Diseases, Ninth Revision, diagnosis codes that indicate status asthmaticus and the use of mechanical ventilation by using procedure codes. We designated hospitals with a PICU as "PICU hospitals" and those without as "adult hospitals." RESULTS: We identified 28 309 admissions of children with status asthmaticus (22.8% of all asthma hospitalizations). From 1992 to 2006, the rate of hospital admissions decreased by half (from 1.98 in 1000 to 0.93 in 1000 children), and there was a 70% decrease in the number of children admitted to adult hospitals. The rate of ICU care in PICU hospitals more than tripled. However, the rate of mechanical ventilation remained low, and the number of deaths was small and unchanged (n = 14 total). Hospital costs climbed from $6.6 million to $9.5 million. CONCLUSIONS: Although fewer children are being admitted with status asthmaticus, the proportion of patients managed in PICUs is climbing. There has been no substantial change in rates of mechanical ventilation or death. Additional research is needed to better understand how patients and physicians decide on the appropriate site for hospital care and how that choice affects outcome.
AB - OBJECTIVE: Status asthmaticus accounts for a large portion of the morbidity and mortality associated with asthma, but we know little about its epidemiology. We describe here the hospitalization characteristics of children with status asthmaticus, how they changed over time, and how they differed between hospitals with and without PICUs. PATIENTS AND METHODS: We used administrative data from New Jersey that included all hospitalizations in the state from 1992, 1995, and 1999-2006. We identified children with status asthmaticus by using International Classification of Diseases, Ninth Revision, diagnosis codes that indicate status asthmaticus and the use of mechanical ventilation by using procedure codes. We designated hospitals with a PICU as "PICU hospitals" and those without as "adult hospitals." RESULTS: We identified 28 309 admissions of children with status asthmaticus (22.8% of all asthma hospitalizations). From 1992 to 2006, the rate of hospital admissions decreased by half (from 1.98 in 1000 to 0.93 in 1000 children), and there was a 70% decrease in the number of children admitted to adult hospitals. The rate of ICU care in PICU hospitals more than tripled. However, the rate of mechanical ventilation remained low, and the number of deaths was small and unchanged (n = 14 total). Hospital costs climbed from $6.6 million to $9.5 million. CONCLUSIONS: Although fewer children are being admitted with status asthmaticus, the proportion of patients managed in PICUs is climbing. There has been no substantial change in rates of mechanical ventilation or death. Additional research is needed to better understand how patients and physicians decide on the appropriate site for hospital care and how that choice affects outcome.
KW - Asthma
KW - Pediatric critical care
KW - Pediatrics
KW - Status asthmaticus
UR - http://www.scopus.com/inward/record.url?scp=77957703718&partnerID=8YFLogxK
U2 - 10.1542/peds.2009-3239
DO - 10.1542/peds.2009-3239
M3 - Article
C2 - 20876177
AN - SCOPUS:77957703718
SN - 0031-4005
VL - 126
SP - 904
EP - 911
JO - Pediatrics
JF - Pediatrics
IS - 4
ER -