title: Factors for poor prognosis of near-fatal asthma after recovery from a life-threatening asthma attack.
abstract: 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.
authors.affiliation: Department of Internal Medicine, College of Medicine Ewha Womans University, Ewha Medical Research Institute, Seoul, Korea.
authors.forename: Myung Shin
authors.initials: MS
authors.lastname: Kim
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Cho
authors.forename: Hee Bom
authors.initials: HB
authors.lastname: Moon
authors.forename: Sang Heon
authors.initials: SH
authors.lastname: Cho
mesh_terms: 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
chemical_list: D005938:Glucocorticoids