Evaluatıon of the patıents who were dıscharged from the pedıatrıc emergency department after treatment for acute asthma attack

Readmission of patients with similar symptoms to pediatric emergency department soon after discharge following treatment for asthma attack comprises a major problem in clinical practice. Our principal aim was to define the ratios (recurrence) of readmission of children with asthma who were discharged from the emergency department following treatment for acute asthma attack and to define the causative factors.The patients with an age range of 3 months ? 18 years who had been admitted to pediatric emergency department due to acute asthma attack and discharged from the emergency department soon after the first treatment during January 2009 ? September 2010 were included in our study. The parents were asked for the persistance of symptoms such as cough, wheezing and dyspnea, drug usage and readmission by telephone calls at day 3 and 7 following discharge from the emergency department.It has been detected that, of the 600 cases included in the study, 72 (%12,0) in the first 72 hours and 16 (%2,7) during 3-7 days were readmitted to the hospital. No significant difference has been shown in between the groups who had been readmitted due to recurrence in the first 72 hours, during 3-7 days and the patients without readmission rearding the average, time of onset of symptoms at first admission, severity of attacks, prophylactic treatment used in the last year, exposure to smoking at home, ipratropiyum bromide and systemic steroid administration at emergency service, asthma attack in the last year and admission to hospital for this reason.Who had had a history of hospitalization were found to have a higher rate of readmission to hospital during day 3-7 due to disease recurrence. It has been shown that the patients who had not received any written plan about self managment at home had a higher rate of readmission in the first 72 hours whereas the patients with maintanance of cough and wheezing at home had a higher rate both in the first 72 hours and at 3-7 days after discharge.Although the recurrence ratios were found to be lower than the similar studies, our study has confirmed that a great majority of patients required additional health services during an attack treatment. In order to reduce this requirement to minimal levels; it has been clarified that emergency service physicians who had first handled the patient should define treatment regarding the course of the disease during the last year, give a written home management plan and discharge the patients under treatment of a drug that could completely control the inflammation developed during acute asthma attack.