Sex-Based Differences in Emergency Department Follow-up With Acute Asthma Exacerbations
Time to first non-emergency department physician follow-up differed by sex in both children and adults.
Women may be more likely than men to return to the emergency department (ED) within 30 days after being discharged after an acute asthma exacerbation, according to a study published in the Journal of Asthma.
A retrospective analysis was performed in 115,853 pediatric and adult patients (40.4% and 59.1% female, respectively) discharged with a principle diagnosis of asthma from an ED in Alberta, Canada, during the course of 12 years. Results showed that 26% of patients seen in the ED were seen again within the study's total observed time, with 5.1% returning within 30 days of discharge.
Return rates for women within 30 days were higher than for men (unadjusted odds ratio [uOR]: 1.26; 95% CI, 1.17-1.36). No statistical significance was found for ED return rates between boys and girls. In addition, girls (unadjusted hazard ratio [uHR]:1.05; 95% CI, 1.03-1.07) and women (uHR: 1.62; 95% CI, 1.59-1.64) were found to have a shorter length of time from ED discharge to non-ED physician follow-up compared with boys and men, respectively.
The investigators concluded that women are more likely than men to return to the ED within 30 days for another acute asthma exacerbation compared with men, despite having a shorter physician follow-up time. However, social and behavioral tendencies in women may have a strong influence on these identified differences and need to be studied more closely.
The researchers also noted that the clinical treatment of asthma in EDs in Alberta may vary and could potentially influence patient outcomes.
Rosychuk R, Ospina M, Zhang J, Leigh R, Cave A, Rowe BH. Sex differences in outcomes after discharge from Alberta emergency departments for asthma: a large population-based study [published online September 5, 2017]. J Asthma. doi:10.1080/02770903.2017.1373805