Early revisits to the emergency department before and after a protocol for adult asthma exacerbations: a retrospective cohort study
Abstract
Objective: To compare revisits to the emergency department (ED) for asthma during the week following discharge and describe associated factors before and after the implementation of an assistance protocol.
Materials y methods: A retrospective cohort study was conducted, including visits for asthma exacerbations in adults to the ED of a university hospital during the periods 2016-2018 (pre-protocol) and 2019-2020 (post-protocol). A multivariate logistic regression model was used, and the odds ratios (OR) with their 95% confidence intervals (95 % CI) were reported. A p-value < 0.05 was considered significant.
Results: Revisits were 38 (31.40%) for the pre-protocol period and 33 (26.61%) for the post-protocol period. In the multivariate regression model, no differences were found in early revisits when comparing the post-protocol period with the pre-protocol period (OR 0.68; 95 % CI: 0.26-1.74; p=0.421). Factors associated with early revisits were age (OR: 1.02; 95 % CI:1.00-1.04; p=0.017), male sex (OR: 0.21; 95 % CI:0.08-0.59: p=0.003), and having had more than one visit to the ED in the last year (OR: 6.19; 95 % CI: 2.48-15.46; p<0.001).
Conclusion: Although early revisits did not decrease after the protocol implementation, age and having had more than one visit to the ED for asthma in the last year were identified as risk factors for revisits within the week, while male sex was a protective factor.
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