Documented Caregiver Report of Wheezing at Home is Associated With Decreased Length of Pediatric Asthma Hospitalizations

Recognition of wheezing by parents of children with asthma is often difficult, potentially delaying care and worsening exacerbations. We evaluated whether caregiver report of wheezing at presentation was associated with hospital outcomes. Using chart review of 732 pediatric asthma admissions over 3 years, symptom and demographic data were extracted from the electronic health record, and regression models examined length of stay (LOS) and pediatric intensive care unit (PICU) admission. Wheezing was reported in 45% of cases and was linked to a 10% shorter LOS (IRR 0.9, 95% CI 0.82-0.99, P = .04). Commonly reported symptoms included shortness of breath (89%), cough (79%), and congestion (47%). Longer LOS was associated with older age (IRR 1.04, 95% CI 1.03-1.06, P < .001) and female sex (IRR 1.14, 95% CI 1.03-1.26, P = .01). No variables predicted PICU admission. These findings suggest under-recognition of wheezing by caregivers may contribute to longer hospitalizations and greater exacerbation severity.