Outcomes following admission to intensive care for asthma
- 1Department of Respiratory Medicine, Royal Children's Hospital Melbourne, Parkville, Australia
- 2Department of Paediatrics, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
- 3Department of Paediatrics, Faculty of Medicine, University of Melbourne, Melbourne, Australia
- 4Paediatric Intensive Care Unit, Royal Children's Hospital Melbourne, Parkville, Australia
- 5Murdoch Children's Research Institute, Melbourne, Australia
- Correspondence to Rina Triasih, Department of Respiratory Medicine, Royal Children's Hospital Melbourne, Flemington Rd, Parkville, Victoria 3052, Australia;
- Accepted 18 March 2011
- Published Online First 3 May 2011
Objective Acute severe asthma in children is a common cause of admission to intensive care units (ICU), but there are few reports on long-term outcomes. This study describes outcomes for children with asthma admitted to an ICU.
Methods All children with asthma aged 2–18 years admitted to the ICU at the Royal Children's Hospital Melbourne between 1990 and 2004 were eligible for the study. Data were collected by reviewing medical records and through telephone interviews.
Results Complete data were obtained for 410 (61%) of 684 eligible patients. The mean duration of follow-up was 10.3±4.6 years. After the index admission, 67% were readmitted to hospital for asthma and 17% to the ICU. Eighty-eight per cent continued to have asthma: 46% had episodic asthma and 42% persistent asthma. Twelve patients (1.8%) subsequently died from asthma. Five per cent of those who required ventilation at their index admission died within 10 years. Risk factors for ICU readmission were admission for asthma in the preceding year (AOR 4.7; 95% CI 2.4 to 9.3) and ventilation at admission (AOR 2.4; 95% CI 1.0 to 5.3). Risk factors for subsequent mortality were multiple ICU admissions (AOR 5.0; 95% CI 1.3 to 19), persistent asthma (AOR 5.8; 95% CI 1.2 to 28.5) and ventilation at admission (AOR 4.5; 95% CI 1.3 to 15.7).
Conclusion Admission to the ICU for asthma is a predictor of hospital readmission. Those with persistent asthma or requiring ventilation are at significant risk of mortality in subsequent years and require close follow-up.
Competing interest None.
Ethics approval This study was conducted with the approval of the Human Research Ethics Committee of the Royal Children Hospital Melbourne, Australia.
Provenance and peer review Not commissioned; externally peer reviewed.