title: Improved outcomes from acute severe asthma in Australian intensive care units (1996 2003).
abstract: BACKGROUND
  There is limited information on changes in the epidemiology and outcome of patients with asthma admitted to intensive care units (ICUs) in the last decade. A database sampling intensive care activity in hospitals throughout Australia offers the opportunity to examine these changes.
  
  
  METHODS
  The Australian and New Zealand Intensive Care Society Adult Patient Database was examined for all patients with asthma admitted to ICUs from 1996 to 2003. Demographic, physiological and outcome information was obtained and analysed from 22 hospitals which had submitted data continuously over this period.
  
  
  RESULTS
  ICU admissions with the primary diagnosis of asthma represented 1899 (1.5%) of 126 906 admissions during the 8-year period. 36.1% received mechanical ventilation during the first 24 h. The overall incidence of admission to ICU fell from 1.9% in 1996 to 1.1% in 2003 (p<0.001). Overall hospital mortality was 3.2%. There was a significant decline in mortality from a peak of 4.7% in 1997 to 1.1% in 2003 (p = 0.014). This was despite increasing severity of illness (as evidenced by an increasing predicted risk of death derived from the APACHE II score) over the 8-year period (p = 0.002).
  
  
  CONCLUSIONS
  There has been a significant decline in the incidence of asthma requiring ICU admission between 1996 and 2003 among units sampled by the Australian and New Zealand Intensive Care Society Adult Patient Database. The mortality of these patients has also decreased over time and is lower than reported in other studies.
authors: Department of Intensive Care, Geelong Hospital, Geelong Australia.
authors: Peter J
authors: PJ
authors: Stow
authors: David
authors: D
authors: Pilcher
authors: John
authors: J
authors: Wilson
authors: Carol
authors: C
authors: George
authors: Michael
authors: M
authors: Bailey
authors: Tracey
authors: T
authors: Higlett
authors: Rinaldo
authors: R
authors: Bellomo
authors: Graeme K
authors: GK
authors: Hart
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D001249:Asthma / Q000401:mortality / Q000628:therapy*; D001315:Australia / Q000453:epidemiology; D003422:Critical Care / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D015999:Multivariate Analysis; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D016896:Treatment Outcome