Impact of race on the severity of acute episodes of asthma and adrenergic responsiveness.
BACKGROUND
African Americans acutely ill with asthma come to emergency departments more frequently and are admitted to hospital more often than whites but the reasons are unclear.


OBJECTIVE
To determine whether such phenomena represent racial differences in attack severity or limited effectiveness of beta(2)-agonist therapy.


RESULTS
We contrasted clinical features, airflow limitation, and albuterol responsiveness in adults acutely ill with asthma, 155 of whom where African American and 140 white, as they presented to eight emergency departments. Assessments were standardized across institutions using a care path, and admission and discharge decisions were made according to predetermined criteria. The degree of obstruction was measured by peak expiratory flow rates. The clinical features of both groups were similar. The African Americans, however, had lower flow rates (p = 0.002), and more of them experienced severe or potentially life threatening episodes (p < 0.001). Albuterol was equally efficacious in both populations and there were no differences in the post-treatment flow rates achieved irrespective of the initial attack intensity. There were no racial differences in admission/discharge ratios.


CONCLUSIONS
Our data indicate that African Americans with asthma tend to present with somewhat more intense attacks than whites, but they respond equally well to routine treatment. Similarly, there were no racial disparities in hospitalizations when standard criteria are employed.
El-Ekiaby
Amr
A
Division of Pulmonary, Critical Care, and Sleep Medicine, Cleveland, OH 44109, USA.
Brianas
Lori
L
Skowronski
Mary E
ME
Coreno
Albert J
AJ
Galan
Gayle
G
Kaeberlein
Frank J
FJ
Seitz
Roy E
RE
Villaba
Karen D
KD
Dickey-White
Howard
H
McFadden
E R
ER
D000208:Acute Disease; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000420:Albuterol / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000208:ethnology* / Q000503:physiopathology; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data*
D000318:Adrenergic beta-Agonists; D000420:Albuterol