A Prospective Multicenter Study of Patient Factors Associated With Hospital Admission From the Emergency Department Among Children With Acute Asthma
Bibliographic record
Abstract
BACKGROUND: Recent studies show that objective measures such as peak flow rates are strongly associated with asthma admission among adults. OBJECTIVE: To identify factors associated with admission among children. METHODS: We performed a prospective cohort study as part of the Multicenter Airway Research Collaboration. Patients aged 2 to 17 years who presented to the emergency department (ED) with acute asthma underwent a structured interview in the ED and another by telephone 2 weeks later. The study was performed at 44 EDs in 18 US states and 4 Canadian provinces. The decision to admit was made at the discretion of the treating physician. Univariate analysis of risk factors for admission was followed by multivariate logistic regression. RESULTS: Of the 1178 eligible subjects, 275 (23%; 95% confidence interval, 21%-26%) were admitted or placed into ED observation units. A multivariate model that included 12 characteristics measured at presentation and during the ED stay was associated with an area under the receiver operating characteristic curve of 0.91. Demographic factors were not independently associated with admission. Severity of symptoms (odds ratio, 1.3) and intensity of therapy both before and during ED visit correlated with the likelihood of admission. Previous admission for asthma (P =.02) and recent use of inhaled corticosteroids (P =.04) also were associated with admission. Peak flows were associated with admission but were infrequently (23% overall) measured. CONCLUSION: Hospitalization for asthma exacerbation in children is primarily associated with clinical indicators in the ED and with historical factors such as previous asthma admission or intubation, recent use of corticosteroids, and comorbidity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".