Abstract
Introduction: While asthma mortality and hospitalizations have decreased substantially over the past two decades, asthma prevalence has increased, and a number of individuals still present with severe asthma. As intensive care unit (ICU) admissions can be used as a marker for severe asthma, there is utility in continuing to monitor ICU trends and the descriptive profile of individuals admitted to the ICU. Methods: Health administrative population data from Ontario, Canada, were used to describe ICU admission trends by age group from 2003 to 2012 and the characteristics of those admitted to ICU. Descriptive analyses were performed for both hospitalized patients and ICU patients for age, sex, rurality, neighborhood income quintile and comorbidities. Results: ICU admission rates per 100,000 asthma population decreased steadily over time (56.4 in 2003; 31.1 in 2012), but increased in the 0-4 (73.9 in 2003; 85.9 in 2012) and 5-14 (11.1 in 2003; 18.8 in 2012) age groups. Compared to individuals who were hospitalized only, a greater proportion of older individuals, females, children with other respiratory conditions, and adults with acute myocardial infarction were admitted to the ICU. Conclusions: While the overall rate of ICU admissions has decreased over time, it has increased in children aged 0-14. This study identified high risk groups who are more likely to be admitted to the ICU. These individuals may benefit from targeted interventions to improve asthma control and reduce their future risk of admission to the ICU.
Highlights
While asthma mortality and hospitalizations have decreased substantially over the past two decades, asthma prevalence has increased, and a number of individuals still present with severe asthma
Asthma intensive care unit (ICU) admission rates per 100,000 asthma population showed that, overall, the rate of patients admitted to the ICU has decreased over time
While the two groups did not have a different proportion of comorbidities as a whole, the ICU group had a greater proportion of children with other respiratory conditions, and adults with acute myocardial infarction (Table 1)
Summary
While asthma mortality and hospitalizations have decreased substantially over the past two decades, asthma prevalence has increased, and a number of individuals still present with severe asthma [1,2]. Those with severe asthma are more likely to have life-threatening asthma exacerbations that can lead to death [2]. Pendergraft et al found that the most common comorbidities within those admitted to the ICU for asthma were pneumonia, hypertension, diabetes mellitus, acute respiratory tract infection, and heart failure [8]
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