Factors for poor prognosis of near-fatal asthma after recovery from a life-threatening asthma attack.
OBJECTIVE
The aim of this study was to investigate poor prognostic factors associated with a near-fatal asthma attack following patient recovery.


METHODS
We enrolled 68 patients who suffered near-fatal asthma attacks and were admitted to the intensive care units of five university hospitals. The patients were divided into two groups. The first group was comprised of patients who discontinued oral corticosteroids within 6 months after being discharged from the hospital and who maintained a forced expiratory volume in 1 s (FEV(1)) >/=60% of the maximum or estimated values of the corresponding patients. The second group included patients who continued on oral corticosteroids for >/=6 months or who maintained a FEV(1) <60%.


RESULTS
In patients with near-fatal asthma, factors for a poor prognosis included older age [48.47+/-3.53 vs. 64.69+/-2.59 years, p<0.05], chronic severe asthma, high values for inflammation-related laboratory markers (ESR, 8.75+/-2.05 vs. 23.88+/-4.40 mm/h, p=0.004; CRP, 1.72+/-0.46 vs. 6.68+/-9.36 mg/dL, p<0.05), asthma exacerbated by pneumonia (28.1 vs. 52.8%, p<0.05), and relatively low nutritional status (albumin, 4.00+/-0.14 vs. 3.51+/-0.10 g/dL, p<0.05).


CONCLUSIONS
These prognostic factors may induce irreversible obstruction of the airways with subsequent acute exacerbation of asthma or the need for continual oral corticosteroids after being discharged from the hospital. Patients with these factors should be treated appropriately, under close surveillance.
Kim
Myung Shin
MS
Department of Internal Medicine, College of Medicine Ewha Womans University, Ewha Medical Research Institute, Seoul, Korea.
Cho
Young Joo
YJ
Moon
Hee Bom
HB
Cho
Sang Heon
SH
D000368:Aged; D001249:Asthma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D015331:Cohort Studies; D003643:Death; D005260:Female; D005541:Forced Expiratory Volume; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012307:Risk Factors
D005938:Glucocorticoids