A60-02 Predictors of Outpatient Attendance Among Children Admitted to Pediatric Intensive Care Unit for Asthma

Abstract Introduction/Rationale Non-attendance at scheduled primary care visits among children with asthma has been linked to increased morbidity and higher healthcare utilization. Known risk factors include non-White race, low medication adherence, low asthma severity, and adolescence. However, the impact of social determinants of health on follow-up care after critical illness is less studied. This study examines whether unmet social needs among pediatric patients admitted to the pediatric intensive care unit (PICU) for asthma are associated with attendance at post-discharge pulmonary follow-up visits and six-month asthma-related morbidity. Methods This retrospective cohort study was conducted over a 24-month period (February 2023-February 2025) at a large urban pediatric center. Families of patients admitted to the PICU for asthma exacerbations were screened for unmet social needs using a checklist that asked about public benefits, household and school asthma issues, and housing or food needs. Demographic characteristics, outpatient follow-up data, pre-admission and post-discharge emergency department (ED) visits and hospitalizations were extracted from a validated citywide pediatric registry. Univariable logistic regression analyses were performed to assess associations between unmet social needs and pulmonary follow-up attendance. Results Among 154 families screened, 65.5% reported one or more social need during the PICU admission, and 32% attended a pulmonary follow-up within 90 days of discharge. The top three reported needs were food needs (37%), household asthma concerns (28.6%), and clothing and household needs (15.5%). No individual social need was a significant predictor of follow-up appointment attendance. Prior engagement with pulmonary medicine before PICU admission was associated with higher odds of follow-up attendance post-discharge (OR 2.91, 95% CI 1.21-7.07). Asthma-related ED visits and hospitalizations in the 12 months prior to PICU admission were also not associated with post-discharge follow-up. Conclusions Among families of critically ill children with asthma, prior engagement with pulmonology care was the strongest predictor of outpatient follow-up after PICU discharge, underscoring the importance of early subspecialty involvement. Although unmet social needs were highly prevalent, they were not independently associated with follow-up attendance in this cohort. These findings suggest that establishing pulmonology care before critical illness may promote continuity and adherence to post-discharge management. This abstract is funded by: None