title: Patients with a longer duration of symptoms of acute asthma are more likely to require admission to hospital.
abstract: OBJECTIVE
  To determine whether, for patients with moderate or severe asthma presenting to emergency departments, there is a difference in need for hospitalization between those with a duration of symptoms less than 6 h and those with a longer duration of symptoms.
  
  
  METHODS
  This prospective, observational study investigated a sample of patients presenting with acute asthma between 21 August and the 3 September 2000, attending study emergency departments and classified as having moderate or severe asthma according to the National Asthma Guidelines. Data collected included duration of symptoms (less than 6 h or greater than 6 h) and disposition following emergency department treatment (home, ward, intensive care unit, high dependency unit, transfer). Data analysis was by Chi square analysis.
  
  
  RESULTS
  Of 381 eligible patients, 348 had sufficient data for entry into this study (33 had missing data). Patients with duration of symptoms more than 6 h were more likely to require hospital admission (P < 0.0001). The relative risk for hospital admission or transfer as opposed to discharge from the emergency department for the group with a duration of symptoms of more than 6 h was 2.2.
  
  
  CONCLUSIONS
  Patients presenting with moderate or severe asthma and a duration of symptoms of more than 6 h are more likely to require hospital admission or transfer for further treatment than patients with a shorter duration of symptoms. This has implications for decision making regarding asthma management and disposition in the emergency department.
authors.affiliation: Department of Emergency Medicine and Joseph Epstein Centre for Emergency Medicine Research, Western Hospital, Footscray, Victoria, Australia. anne-maree.kelly@wh.org.au
authors.forename: Anne-Maree
authors.initials: AM
authors.lastname: Kelly
authors.forename: Colin
authors.initials: C
authors.lastname: Powell
authors.forename: Debra
authors.initials: D
authors.lastname: Kerr
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001249:Asthma; D002648:Child; D002675:Child, Preschool; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors