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1086: SOCIAL DEMOGRAPHICS OF PATIENTS REQUIRING MECHANICAL VENTILATION DUE TO ASTHMA EXACERBATION

Introduction/Hypothesis: The Global Initiative for Asthma (GINA) 2019 guidelines defines asthma as a heterogeneous disease characterized by chronic airway inflammation. While maintenance therapy is often effective, a characteristic of asthma is its variable intensity, which can lead to severe life-threatening exacerbations. We attempt to describe the social demographics and pertinent outcomes of asthma exacerbations associated with the need for mechanical ventilation. Methods: We conducted a retrospective cohort study using data from the 2015 National Inpatient Sample (NIS). Our inclusion criteria included patients with a principal diagnosis of asthma exacerbation requiring mechanical ventilation secondary to respiratory failure. We excluded subjects <18 years of age, and those admitted for pneumonia, COPD or heart failure exacerbation. ICD-9,10 codes were used to identify the diagnoses. We analyzed the demographic characteristics of patients requiring mechanical ventilation and stratified patients based on their age, sex, insurance, median income in zip code and urban residence location. We also examined in-hospital mortality, length of stay (LOS), total hospitalization charges and costs, and Charlson comorbidity score. Results: 1345 patients fit our above criteria. Of these, 64.21% were female. With respect to race, whites accounted for 40.99%, and blacks 35.63% of the studied sample. A majority of this population were covered by Medicaid (38.22%). Patients from central counties of metro areas of >= 1 million population comprised 39.55% of the total. Of particular interest, the largest proportion of these admissions (36.09%) came from the lower-income bracket ($1-$42999). In terms of comorbidity assessment, 75.09% had a Charlson index of 1. In-hospital mortality was 7.06% (+0.15 95% CI 0.045-0.107), mean LOS was 6.4 days (+0.52 95% CI 5.38-7.42) and mean total hospital charges were $85,799. Conclusions: Asthma exacerbations requiring mechanical ventilation leads to increased lengths of stay, costs, and poorer outcomes. The understanding of patient demographics and outcomes gives us an opportunity to identify areas and patient populations that need better access to primary healthcare and disease awareness. This could reduce ICU admissions, thus decreasing the heavy financial burden borne by the community.