Intensive care unit (ICU) admissions represent a key marker of asthma severity and identify patients at greatest risk for asthma-related morbidity and mortality. Tracking changes in ICU-level care and the severity of admissions over time provides population-level insight into whether the burden of severe asthma is shifting and whether management strategies are affecting outcomes.
The study aimed to assess temporal trends in ICU admission rates and the severity of those admissions among people with prevalent asthma aged 0–59 years in Ontario, Canada, over a 10-year period.
Researchers assembled a 10-year cross-sectional cohort using population-based health administrative databases covering the years 2013–2022. The cohort included individuals with prevalent asthma aged 0–59 years. All-cause ICU admissions were identified when asthma or an asthma-related condition was recorded as the most responsible diagnosis for the hospital admission.
Annual rates were calculated for the following outcomes: asthma hospital admissions, ICU admissions, invasive ventilation, in-hospital mortality, and average length of stay in hospital. Trends were compared over time, and characteristics of patients admitted to hospital who did and did not require ICU-level care were evaluated.
The authors specifically noted analyses that excluded the COVID-19 pandemic period (2020–2022) for some comparisons to account for pandemic-related effects on healthcare utilization and respiratory admissions.
Over the 10-year period from 2013 to 2022, there were 7,870 ICU admissions among 52,919 patients admitted to hospital with asthma. More than 30% (2,685) of ICU admissions occurred in children younger than 6 years of age.
When excluding the COVID-19 pandemic period (2020–2022), overall hospital admission rates for asthma remained stable. Key subgroup and outcome findings were:
Adults (age not further disaggregated in the abstract): no significant change in ICU admission rates (p = 0.45) and no significant change in invasive ventilation rates (p = 0.21) over the study interval. However, average hospital length of stay for adult admissions increased significantly (p < 0.0001).
Children (<18 years): there was a significant increase in ICU admission rates over time (p < 0.0001). At the same time, the average hospital length of stay for pediatric admissions decreased (p = 0.022). There was a trend toward decreasing invasive ventilation rates in children, though this did not reach conventional statistical significance (p = 0.073).
In-hospital mortality across the cohort did not change significantly during the study period.
These results indicate divergent patterns by age group: adult admissions showed stable measures of severity except for longer hospital stays, while pediatric admissions showed higher ICU utilization but shorter hospital stays and a trend toward less invasive ventilation.
According to the study abstract, ICU admission rates for asthma have not decreased over the last decade in this Ontario population. In adults, measured severity of ICU admissions did not improve over time, with a significant increase in hospital length of stay. In children, ICU admission rates increased significantly, but hospital stays were shorter and there was a non-significant trend toward decreased invasive ventilation. There was no significant change in in-hospital mortality across the study period.
Overall, the findings suggest persistent or shifting burdens of severe asthma requiring ICU-level care, with age-specific differences that may reflect changes in clinical practice, pediatric case mix, or other system-level factors not detailed in the abstract.
The abstract does not provide detailed limitations, granular demographic breakdowns beyond the noted age groups, or specific explanations for the observed temporal trends. Any additional methodological limitations, risk of residual confounding, or sensitivity analyses were not reported in the source abstract.
Keywords reported in the abstract: Critical care; health services research; respiration.
Citation details provided in the source abstract: Annals of the American Thoracic Society. 2026 Aug 10: aaoag247. DOI: 10.1093/annalsats/aaoag247. PubMed PMID: 42573522.