680:
CHRONIC RHINITIS AND THE RISK OF EARLY ASTHMA READMISSION - A RETROSPECTIVE COHORT STUDY
Monday, March 5, 2018
South Hall A2 (Convention Center)
Umesh Singh, MD PhD MBA MHI, Victoria Wangia-Anderson, PhD, Jonathan A. Bernstein, MD FAAAAI
RATIONALE: Early hospital readmission (i.e., within 30-days of index admission) concerns most healthcare stakeholders. Comorbid conditions increase the risk of such readmissions. The characteristics of 30-day asthma-related readmission rate (30d-AR-RR) and the comorbidities significantly influencing the risk were investigated in this study. Objectives were to examine the hypothesis that allergic/non-allergic rhinitis (AR/NAR) among other comorbidities can influence 30d-AR-RR.

METHODS: A retrospective hospital-based database study was performed using the University of Cincinnati Hospital (UCH) data from all-payer hospital inpatient stays of patients aged 3-99, hospitalized for asthma exacerbation between mid-2012-mid-2017. Initially, all asthma-related admissions were extracted from the database. Those patients readmitted ≤30-days at UCH and their comorbidities were identified. Primary outcome was 30d-AR-RR between AR/NAR vs. non-rhinitis patients. Chi-square test and multivariate logistic regression were used to examine associations between 30d-AR-RR and patient demographics or comorbidities.

RESULTS: Between 2012-2017 there were 10,111 asthma-related hospital encounters. Of these, 1,670 (16.52%) were readmissions within 30-days. Specifically, the odds of 30d-AR-RR were significantly higher in patients with AR/NAR [vs. non-rhinitis patients; OR=4.3 (AR), 4.9 (NAR) p<0.0001] after adjustment for significant other comorbidities (i.e., tobacco smoking). The average number of 30d-readmissions for AR/NAR were ~5.4/5.8 (vs. 1.7/1.9 for non-rhinitis). The cumulative risk of 30d-AR-RR also was significantly higher for AR/NAR patients.

CONCLUSIONS: Asthma is a high-priority health and economic burden in the US. Early readmissions worsen this burden. Comorbid chronic rhinitis had a significant effect on the 30-d-AR-RR suggesting that further investigation is warranted to determine if its proper diagnosis and treatment reduces related healthcare costs.