Initial ED Oxygen Saturation ≤90% Increases the Risk of a Complicated Hospital Course in Pediatric Asthmatics Requiring Admission

Document Type

Article

Publication Date

9-1-2019

Publication Title

American Journal of Emergency Medicine

Volume

37

Issue

9

First page number:

1743

Last page number:

1745

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

Pediatrics; Asthma; Pulse oximetry; Admission

Disciplines

Medical Specialties | Medicine and Health Sciences | Pediatrics

Language

English

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