Treatment and outcome of adult patients with acute asthma in emergency departments in Australasia, South East Asia and Europe: Are guidelines followed? AANZDEM/EuroDEM study.
Adolescent
Adult
Aged
Aged, 80 and over
Asia, Southeastern
/ epidemiology
Asthma
/ epidemiology
Australasia
/ epidemiology
Bronchodilator Agents
/ therapeutic use
Cohort Studies
Emergency Service, Hospital
/ organization & administration
Europe
/ epidemiology
Female
Guidelines as Topic
Humans
Interrupted Time Series Analysis
Male
Middle Aged
Outcome and Process Assessment, Health Care
/ methods
Prospective Studies
Treatment Outcome
asthma
dyspnoea
emergency department
management
outcome
Journal
Emergency medicine Australasia : EMA
ISSN: 1742-6723
Titre abrégé: Emerg Med Australas
Pays: Australia
ID NLM: 101199824
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
06
11
2018
revised:
08
01
2019
accepted:
09
01
2019
pubmed:
26
2
2019
medline:
9
6
2020
entrez:
27
2
2019
Statut:
ppublish
Résumé
Asthma exacerbations are common presentations to ED. Key guideline recommendations for management include administration of inhaled bronchodilators, systemic corticosteroids and titrated oxygen therapy. Our aim was to compare management and outcomes between patients treated for asthma in Europe (EUR) and South East Asia/Australasia (SEA) and compliance with international guidelines. In each region, prospective, interrupted time series studies were performed including adult (age >18 years) patients presenting to ED with the main complaint of dyspnoea during three 72 h periods. This was a planned sub-study that included those with an ED primary diagnosis of asthma. Data was collected on demographics, clinical features, treatment in ED, diagnosis, disposition and in-hospital outcome. The results of interest were differences in treatment and outcome between EUR and SEA cohorts. Five hundred and eighty-four patients were identified from 112 EDs (66 EUR and 46 SEA). The cohorts had similar demographics and co-morbidity patterns, with 89% of the cohort having a previous diagnosis of asthma. There were no significant differences in treatment between EUR and SEA patients - inhaled beta-agonists were administered in 86% of cases, systemic corticosteroids in 66%, oxygen therapy in 44% and antibiotics in 20%. Two thirds of patients were discharged home from the ED. The data suggests that compliance with guideline-recommended therapy in both regions, particularly corticosteroid administration, is sub-optimal. It also suggests over-use of antibiotics.
Identifiants
pubmed: 30806041
doi: 10.1111/1742-6723.13242
doi:
Substances chimiques
Bronchodilator Agents
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
756-762Subventions
Organisme : Department of Health
ID : PDF-2012-05-193
Pays : United Kingdom
Organisme : Research Council of Lithuania
ID : MIP-049/2015
Pays : International
Organisme : Queensland Emergency Medicine Research Foundation
ID : EMPJ-108R21-2014
Pays : International
Informations de copyright
© 2019 Australasian College for Emergency Medicine.
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