[The patterns of use and factors associated with the patient admission of hospital emergencies for asthma and chronic obstructive pulmonary disease].
The aim of this study was to describe the epidemiological characteristics of emergencies caused by asthma and chronic obstructive pulmonary disease (COPD) at the Hospital Clínico Universitario of Valencia (Spain) and to analyze factors related to hospital admissions for the same causes. Emergency room medical records for 1993 to 1995 of patients older than 14 years of age were examined to identify those due to asthma or COPD, according to established protocol. Demographic variables were described, followed by Poisson regression analysis of time and seasonal factors affecting emergencies. Factors related to hospital admission were analyzed by logistic regression, taking into account age group, sex, place of residence, and the year, month, day and hour of emergency room arrival. Asthma patients amounted to 1% of emergencies, while COPD patients accounted for 2%. The admission rate for women with asthma was higher than for men (F/M ratio = 0.78), whereas the rate for men with COPD was higher than for women (F/M ratio = 3.14). The largest age groups with asthma emergencies included young people aged 15 to 24 years old and those over 60. Hospital admissions or transfers to other hospitals were ordered for 17.4% of asthma patients and 38.8% of COPD patients. Nearly a third of COPD patients and a fifth of asthma patients were readmitted within the ten days following the first emergency. Clear temporal patterns of COPD emergency were observed for month (most occurring in winter), day of the week (most on Monday) and hour of the day (most during daytime hours, with fewer at midday). The time patterns were less evident for asthma emergencies, although the likelihood of admission because of asthma varied by month and day of the week. Emergency room records may be useful for studying the patterns of respiratory disease presentation. Other possible uses are epidemiologic monitoring and evaluation of health care quality.
Unidad de Epidemiología y Estadística, Institut Valencià d'Estudis en Salut Pública--IVESP. fballest@san.gva.es
F
F
Ballester
S
S
Pérez-Hoyos
M L
ML
Rivera
T
T
Merelles
J M
JM
Tenías
J B
JB
Soriano
J
J
Marín
J M
JM
Antó
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology / Q000628:therapy*; D004630:Emergencies; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends*; D012621:Seasons; D013030:Spain / Q000453:epidemiology; D013383:Suburban Population; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data