A60-08 Correlating Asthma Phenotypes and Status Asthmaticus Interventions Requiring Critical Care

Abstract Rationale Children with uncontrolled or severe asthma are more likely to demonstrate a Type 2-high asthma phenotype, putting them at high-risk for developing status asthmaticus requiring numerous interventions to reverse their symptoms and making them prime candidates for admission to a pediatric intensive care unit (PICU). While there are biochemical markers for identifying Type 2-high phenotypes, few clinical biomarkers have been identified in this pediatric population. We explored if children requiring PICU admission for status asthmaticus demonstrate a correlation between the number of clinical interventions required for stabilization and biomarker evidence of Type 2-high asthma phenotypes. Methods A single-center retrospective chart review evaluated admission data from 2018-2023 for children ages 6-18 diagnosed with persistent or unspecified asthma, admitted to the PICU in status asthmaticus, and who completed at least 1 outpatient encounter with an asthma specialist. We analyzed inpatient interventions required for immediate clinical stabilization in the emergency department (ED) and PICU. Patient admission data was correlated with their biomarkers, with preference for outpatient data collected within one year before or after admission. Frequency tables were generated for categorical variables, and descriptive statistics were summarized for continuous variables. Generalized Estimating Equation for repeated measures were used with Poisson or Gamma distribution and log link function. Results 278 patients met inclusion criteria, and 174 patients were included in the final analysis. A total of 231 admissions occurred during the time frame. Moderate or severe persistent asthma were the most common diagnoses (n = 146, 84%). The most frequent comorbidities included allergic rhinitis (n = 145, 83%), atopic dermatitis (n = 105, 60%), and obesity (n = 71, 41%). A majority of patients had at least one positive biomarker (n = 139, 60%). There was a non-significant trend towards a higher number of clinical interventions required in the ED and PICU for stabilization in patients with at least one biomarker (Table 1, p-value 0.15). There was no correlation found between the presence of biomarkers and their hospital length of stay and hospital charges for admission. Conclusion A trend was identified with biomarkers and the number of clinical interventions required for stabilization for status asthmaticus requiring critical care, though no statistical significance was reached. This study is ongoing and will continue to collect data to identify clinical relationships of Type 2-high asthmatics in status asthmaticus. This abstract is funded by: None