A population-based study of emergency department presentations for asthma in regions of Alberta

Abstract

Objective:We describe the epidemiology of asthma presentations to emergency departments (EDs) for 3 main regions in the province of Alberta. Methods: We used a comprehensive ED database to identify ED visits in Alberta from April 1999 to March 2005. We linked the visits to other provincial administrative databases to obtain all data on follow-up encounters for asthma during that period. Information extracted included demographics, regions of residence (Edmonton, Calgary or non-major urban [NMU]), timing of ED visits, and subsequent visits to non-ED settings. Data analysis included descriptive summaries and directly standardized visit rates. Results: During the 6-year study period, 93 146 patients made 199 991 ED visits for asthma. Crude rates in 2004/05 were 7.9/1000, 6.5/1000 and 15.4/1000 in the Edmonton, Calgary and NMU regions, respectively. The Edmonton and Calgary re gions had consistently lower visit rates than the NMU regions. The ED visits were followed by low rates of follow-up visits in a variety of non-ED settings, at different intervals. Conclusion: Asthma is a relatively common presenting problem in Alberta EDs. This study identified relatively stable rates of presentation during the study period, and variation among regions in terms of age and sex. This study provides further understanding of the variation associated with ED presentation and indicates possible targets for specific interventions to reduce asthma-related ED visits.

Respiratory Distress Syndrome at Birth Is a Risk Factor for Hospitalization for Lower Respiratory Tract Infections in Infancy

“…The diagnostic codes used were consistent with those used in other administrative database studies. 24,33,[35][36][37][38][39][40][41][42] The RAMQ databases have been shown to have high sensitivity (97%) and specificity (92%) for identifying details of an individual's pregnancy and delivery, 43 to have high sensitivity (85%) and specificity (95%) for identifying individuals with asthma 44 and to differentiate between diagnoses of chronic obstructive pulmonary disease and asthma. 45 Although we did not find any specific assessments of the validity of ICD codes used to identify RDS, these codes are likely highly reliable as they would be provided by trained hospital nosologists with uniformity in coding from use of a common guideline to classify outcomes.…”

Association between allergic rhinitis and asthma in a Northern Alberta cohort

“…It is possible that patients with initially normal PFTs may subsequently develop evidence of lower airway disease if followed over time. Finally, the overall prevalence of asthma in Canada varies between 5 and 10%, with Alberta reporting the highest rates in Canada of up to 10.2% [22], [23]. Thus, the results of our study may not be applicable to other regions.…”

Developments in asthma incidence and prevalence in Alberta between 1995 and 2015

“…Although there are no recent publications on the prevalence of asthma in Alberta, there are several publications reporting on emergency care for asthma in Alberta that make use of databases. A study on the rates of asthma presentations in ED from 1999 to 2011 showed that the number of ED presentations has been declining during that period 10 . Rosychuk showed that during a similar period (1999-2005) there were higher rates of ED visits in non-urban areas of Alberta compared to Edmonton and Calgary, with crude rates in 2004/05 of 7.9/1000, 6.5/1000 and 15.4/1000 in the Edmonton, Calgary and non-urban areas, respectively.…”

“…In Alberta, there are several high-quality studies using provincial databases 10,11,12 , reporting on the epidemiology of emergency department (ED) visits for asthma, including a publication from Rosychuk et al showing that ED visits for asthma declined from 1999 to 2011 13 . However, these studies were restricted to patients visiting an ED; and did not address important questions such as age and sex differences and trends over time, and mortality differences and trends.…”