FACTORS ASSOCIATED WITH FREQUENT EMERGENCY DEPARTMENT VISITS FOR ACUTE EXACERBATION OF ASTHMA, IN A TERTIARY CARE HOSPITAL, KARACHI

Abstract

Objective: To identify the factors associated with frequent emergency department (ED) visits among children presenting with acute asthma exacerbations in a tertiary care hospital in Karachi. Study Design: Cross-sectional study. Place and Duration of Study: Paediatric Emergency Department, Indus Hospital and Health Network (IHHN), Karachi, from June 2025 to December 2025. Methodology: A total of 189 children aged 2–14 years presenting with acute asthma exacerbation were enrolled through consecutive sampling. Demographic characteristics, socioeconomic status, environmental exposures, ICS compliance, inhaler technique, and follow-up practices were recorded using a structured proforma. Results: Poor ICS compliance (72% vs. 30%, p<0.01), incorrect or unskilled inhaler technique (65% vs. 34%, p<0.02), passive smoking exposure (62% vs. 38%, p<0.03), and biomass exposure (67% vs. 45%, p<0.05) were significantly associated with frequent ED visits (≥3 visits/year). Lower parental education, longer duration of illness, and follow-up intervals exceeding three months were also significant predictors. Conclusion: Frequent ED visits among children with asthma were primarily associated with modifiable factors, including poor treatment adherence, incorrect inhaler technique, smoke exposure, and irregular follow-up.