Introduction

Children admitted to the intensive care unit (ICU) for asthma are at higher risk of future morbidity and mortality. Although Canada and the United States (US) may have different population compositions, studies have documented that up to 34% of American children hospitalized for asthma require ICU admission, compared to 4.5% in Canada. However, whether there are differences in the post-ICU asthma-related morbidity between the two countries is not known. This study compared the post-ICU asthma-related readmissions and ICU readmissions in children with critical asthma between Canada and the US.

Methods

In this retrospective cohort study, we included children aged 2–17 years with an ICU admission for asthma in a pan-Canadian database (2008–2014) and a 4-state American database (2005–2014). The time to the first asthma-related readmission, the distribution of asthma-related readmissions within 1 year, and the proportion of ICU readmissions within 1 year were compared between the 2 countries.

Results

1055 Canadian and 9377 American children were admitted to the ICU for asthma during the study period. The time to asthma-related readmission (p = 0.29) and the frequency of asthma-related readmissions within 1 year (p = 0.73) did not differ between Canada and the US. However, the proportion of children readmitted to the ICU for asthma within 1 year was significantly higher in the US (US: 40.1%, Canada: 28.9%; p = 0.02).

Conclusion

While the overall asthma-related readmissions in children with critical asthma did not differ between Canada and the US, a greater proportion of children were readmitted to the ICU in the US. Future studies should elucidate the causes underlying this difference.

中文翻译：

---

儿童严重哮喘后与哮喘有关的住院治疗：加拿大和美国之间的比较。

介绍

因哮喘而入住重症监护病房（ICU）的儿童，未来发病和死亡的风险更高。尽管加拿大和美国的人口组成可能不同，但研究表明，高达34％的因哮喘住院的美国儿童需要入住ICU，而加拿大为4.5％。但是，两国之间ICU后哮喘相关发病率是否存在差异尚不清楚。这项研究比较了加拿大和美国之间重症哮喘儿童的ICU后哮喘相关的再入院率和ICU的再入院率。

方法

在这项回顾性队列研究中，我们在泛加拿大数据库（2008-2014年）和美国四州数据库（2005-2014年）中纳入了2-17岁患有ICU哮喘的儿童。比较了这两个国家的第一次哮喘相关再入院时间，一年内哮喘相关再入院的分布以及一年内ICU再入院的比例。

结果

在研究期间，有1055名加拿大儿童和9377名美国儿童被送入ICU进行哮喘治疗。加拿大和美国之间，与哮喘相关的再入院时间（p = 0.29）和一年内与哮喘相关的再入院频率（p = 0.73）没有差异。但是，在美国，一年内再次入住ICU哮喘的儿童比例明显更高（美国：40.1％，加拿大：28.9％； p = 0.02）。

结论

尽管在加拿大和美国之间，重症哮喘儿童的总体与哮喘相关的再入院率没有差异，但在美国，有较大比例的儿童被重新接纳为ICU。未来的研究应阐明造成这种差异的原因。