Influence of age, sex and respiratory viruses on the rates of emergency department visits and hospitalisations with respiratory tract infections, asthma and COPD

Abstract

BackgroundThe importance of age, sex and respiratory virus prevalence to Emergency Department (ED) visits and hospitalisations for respiratory tract infections (RTIs), asthma, and chronic obstructive pulmonary disease (COPD) in a whole population over time is not well established.MethodsThis study retrospectively analysed data for the daily ED visits and hospitalisations from 2003–2013 in Ontario, Canada and the daily number of virus positive tests. Daily numbers of ED visits and hospitalizations with RTIs, asthma, and COPD listed as a primary diagnosis were collected from the Canadian Institute for Health Information. Virus data were obtained from the Respiratory Virus Detection Surveillance System. Multiple linear regression was used to assess the association of individual viruses with the daily rates.ResultsThere were 4 365 578 ED visits and 321 719 admissions for RTIs (7.4%), 817 141 ED visits and 260 665 admissions for COPD (31.9%), and 649 666 ED visits and 68 626 (10.6%) admissions for asthma. Respiratory syncytial virus and influenza A were associated with male ED visits, whereas human rhinovirus was associated with female ED visits for RTIs in preschool children; 19.2% of males, but only 7.2% of females were admitted. The correlation between the prevalence of each virus and ED visits and hospitalisations for asthma was weak irrespective of age group and sex. Influenza A was most strongly associated with COPD ED visits and hospitalizations in males and females.ConclusionsThere are significant age and sex differences in the contribution of respiratory viruses to the number of ED visits and hospitalizations for RTIs, asthma, and COPD.

Dynamic changes of emergency visits: a retrospective observational study

“…The possible reason for the higher number of female patients is that the average life expectancy of women is greater than that of men, and women are more aware of health care than men. This is consistent with the related reports of Satia I [ 8 ] and Rozario SS [ 9 ].…”

Acuity of asthma exacerbations in Alberta, Canada is increasing: a population-based study

“…There were sex differences in our data, with women showing consistently higher rates of ED visits and hospitalization than men. This is consistent with prior Canadian data showing that elderly women are less likely to have spirometry, physician visits for asthma, or controller medication prescription than elderly men [ 13 , 14 ]. In Alberta, women presenting to the ED for asthma are more likely to return within 30 days than men [ 15 ].…”

Single points of access to fill the “GAP” for unattached patients in primary care: What makes paediatric users more likely to require a medical appointment?

“…First, infants are more vulnerable to complications (e.g., respiratory distress and dehydration) of undiagnosed or untreated conditions, especially infections (e.g., bronchiolitis, pneumonia, otitis, and gastroenteritis). 18 Also, because they cannot express their symptoms at that age, it is even more challenging for the parent and the on-line evaluator to have a clear idea of what is happening. Thus, safety concerns may explain why this group is more likely to require a medical appointment than older groups.…”

“…13,14 Furthermore, paediatric patients represent 22% of emergency department visits in Quebec, 15 a proportion bound to rise during seasons of high virus circulation in the context of inaccessible primary care. [16][17][18] Given the significant population of children and adolescents without a regular PCP and the limited data on the single points of access recently implemented across the province, our study will fill gaps in the literature (1) by providing data on the sociodemographic and clinical characteristics of the paediatric population using the GAP service and (2) by identifying the characteristics that make some paediatric patients more prone to require a medical appointment at the end of the assessment process. Such information is relevant to decision-and policymakers who intend to implement a similar initiative in their jurisdiction.…”

“… 13 , 14 Furthermore, paediatric patients represent 22% of emergency department visits in Quebec, 15 a proportion bound to rise during seasons of high virus circulation in the context of inaccessible primary care. 16 - 18 …”