"Characteristics of patients admitted to emergency department for asthma attack: a real-LIFE study".
Administration, Inhalation
Adolescent
Adrenal Cortex Hormones
/ administration & dosage
Adult
Anti-Asthmatic Agents
/ administration & dosage
Asthma
/ drug therapy
Child
Emergency Service, Hospital
/ statistics & numerical data
Female
Humans
Italy
Logistic Models
Male
Middle Aged
Multivariate Analysis
Nebulizers and Vaporizers
Patient Discharge
/ statistics & numerical data
Practice Guidelines as Topic
Young Adult
Adult asthma
Allergic asthma
Anti-asthmatic drugs
Asthma attack
Asthma therapy
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
17 Jun 2019
17 Jun 2019
Historique:
received:
24
01
2019
accepted:
06
06
2019
entrez:
19
6
2019
pubmed:
19
6
2019
medline:
18
12
2019
Statut:
epublish
Résumé
Asthma is a chronic disease affecting 30 million people in Europe under 45y. Poor control of Asthma is the main cause of emergency-department (ED) access, becoming the strongest determinant of the economic burden of asthma management. To examine the characteristics of adult patients admitted to ED for acute asthma attack, focusing on previous diagnosis of asthma (DA) and current therapy. During a one-year period, a structured questionnaire, assessing asthma diagnosis and management, was administered to all patients admitted for asthma attack, to the ED of a South-Italy town. Only patients with subsequently confirmed asthma were enrolled. The data on oxygen saturation (Sat.O2), heart and respiratory-rate, severity code ED-admission, hospitalization or discharge, had been obtained. Two hundred one patients (mean 50.3ys), were enrolled. One hundred eighteen had a DA, made 17.5 ± 5.88 years before, and 35.6% had a specialist-examination in the last year. 53.3% of DA-patients used a self-medication before ED access with short-acting-beta-2-agonist and oral-corticosteroids, although none had a written-asthma-action-plan (WAAP). Almost all DA-patients were on regular therapy: inhaled-corticosteroids (ICS) in 61%, associated with LABA in 85%. 16.7% of DA-patients had previous DA-access. The overall hospitalization-rate was 39%, higher in DA compared to unknown asthmatic patients (UA)(p = 0.017). Significant risk factors for hospitalization were Sat-O2 ≤ 94% breathing ambient air (OR9.91, p < 0.001), inability-to-complete a sentence (OR9.42,p < 0.001) and the age (OR1.02,p = 0.049). Despite the asthma guidelines-recommendation, up to 40% of patients received the asthma diagnosis in ED, only 61% of DA-patients were taking ICS. It is disappointing that DA-patients did not have a WAAP, which could explain the poor patient-self-medication at ED admission.
Sections du résumé
BACKGROUND
BACKGROUND
Asthma is a chronic disease affecting 30 million people in Europe under 45y. Poor control of Asthma is the main cause of emergency-department (ED) access, becoming the strongest determinant of the economic burden of asthma management.
OBJECTIVE
OBJECTIVE
To examine the characteristics of adult patients admitted to ED for acute asthma attack, focusing on previous diagnosis of asthma (DA) and current therapy.
METHODS
METHODS
During a one-year period, a structured questionnaire, assessing asthma diagnosis and management, was administered to all patients admitted for asthma attack, to the ED of a South-Italy town. Only patients with subsequently confirmed asthma were enrolled. The data on oxygen saturation (Sat.O2), heart and respiratory-rate, severity code ED-admission, hospitalization or discharge, had been obtained.
RESULTS
RESULTS
Two hundred one patients (mean 50.3ys), were enrolled. One hundred eighteen had a DA, made 17.5 ± 5.88 years before, and 35.6% had a specialist-examination in the last year. 53.3% of DA-patients used a self-medication before ED access with short-acting-beta-2-agonist and oral-corticosteroids, although none had a written-asthma-action-plan (WAAP). Almost all DA-patients were on regular therapy: inhaled-corticosteroids (ICS) in 61%, associated with LABA in 85%. 16.7% of DA-patients had previous DA-access. The overall hospitalization-rate was 39%, higher in DA compared to unknown asthmatic patients (UA)(p = 0.017). Significant risk factors for hospitalization were Sat-O2 ≤ 94% breathing ambient air (OR9.91, p < 0.001), inability-to-complete a sentence (OR9.42,p < 0.001) and the age (OR1.02,p = 0.049).
CONCLUSION
CONCLUSIONS
Despite the asthma guidelines-recommendation, up to 40% of patients received the asthma diagnosis in ED, only 61% of DA-patients were taking ICS. It is disappointing that DA-patients did not have a WAAP, which could explain the poor patient-self-medication at ED admission.
Identifiants
pubmed: 31208388
doi: 10.1186/s12890-019-0869-8
pii: 10.1186/s12890-019-0869-8
pmc: PMC6580601
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Anti-Asthmatic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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