"Characteristics of patients admitted to emergency department for asthma attack: a real-LIFE study".

Abstract

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:

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:

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:

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:

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.

• Authors: Laura Losappio, Enrico Heffler, Rossella Carpentiere, Monica Fornero, Cosimo Damiano Cannito, Francesco Guerrera, Francesca Puggioni, Riccardo Monti, Stefania Nicola, Giovanni Rolla, Luisa Brussino
• Journal: BMC pulmonary medicine (BMC Pulm Med) Vol. 19 Issue 1 Pg. 107 (Jun 17 2019) ISSN: 1471-2466 [Electronic] England
• PMID: 31208388 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Anti-Asthmatic Agents

Topics

• 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