Abstract
Emergency physicians are responsible for admitting children with asthma who do not
respond to initial therapy. We examined the hypothesis that an initial room air pulse
oximetry ≤90% elevates the risk of a complicated hospital course in children who require
admission with acute asthma.
Methods
Charts of all patients ages 2 years–17 years admitted for asthma from January 2017
to December 2017 were reviewed. An explicit chart review was performed by trained
data extractors using a standardized form. Results: A total of 244 children meeting
inclusion criteria were admitted for asthma from the ED during the study period. All
patients had an initial room air pulse oximetry documented. Sixty-five were admitted
to PICU status (27%), and 179 (73%) were admitted to floor status. The relative risk
of a complicated course in those patients presenting with a saturation of ≤90% was
11.3 (95% CI 3.9–32.6). The mean initial pulse oximetry on patients with a complicated
course was 85% versus 93% for those without a complicated course (p < 0.005).
Conclusion
Our data suggest that in pediatric asthmatics that require admission from the ED,
those with pulse oximetry readings less than or equal to 90% on presentation are at
higher risk of a complicated hospital course.
Keywords
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Article Info
Publication History
Published online: June 14, 2019
Accepted:
June 13,
2019
Received in revised form:
May 18,
2019
Received:
April 21,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
