title: Perception of airflow obstruction in patients hospitalized for acute asthma.
abstract: BACKGROUND
  Little is known about the perception of airflow obstruction in patients hospitalized for acute asthma.
  
  
  OBJECTIVE
  To evaluate patient perception of airflow obstruction at hospital discharge and at a 2-week follow-up visit and to determine whether symptom control and/or severity of airflow obstruction identified patients at risk for acute asthma after discharge.
  
  
  METHODS
  In a prospective cohort study of inner-city adults hospitalized for acute asthma from April 1, 2001, through October 31, 2002, symptom control (Asthma Control Questionnaire) and airflow obstruction (forced expiratory volume in 1 second [FEV1] percentage predicted) were evaluated at discharge and 2 weeks after discharge. We evaluated perception of airflow obstruction (symptom control vs FEV1 percentage predicted) and perception of change in airflow obstruction (change in symptom control vs percentage change in FEV1) between the 2 visits. Acute asthma after discharge was defined as an emergency department visit or hospitalization for asthma within 90 days of discharge.
  
  
  RESULTS
  In fifty-one participants, symptom control was not significantly associated with airflow obstruction at hospital discharge (P = .30), indicating poor perception of airflow obstruction. Among the 41 participants (80.4% of those enrolled) who completed the follow-up visit, change in symptom control was not significantly associated with change in airflow obstruction (P = .20), indicating poor perception of change in airflow obstruction. Greater airflow obstruction at follow-up (P = .02) and a smaller improvement in airflow obstruction (P = .03), but not symptom control, were associated with a higher risk of acute asthma after discharge.
  
  
  CONCLUSIONS
  Patients hospitalized for acute asthma have poor perception of airflow obstruction and change in airflow obstruction. Objective measurements of lung function should guide treatment decisions after discharge in this population.
authors: Department of Medicine, University of Chicago, Chicago, Illinois, USA.
authors: Steven Q
authors: SQ
authors: Davis
authors: Zachary
authors: Z
authors: Permutt
authors: Solbert
authors: S
authors: Permutt
authors: Edward T
authors: ET
authors: Naureckas
authors: Andrew L
authors: AL
authors: Bilderback
authors: Cynthia S
authors: CS
authors: Rand
authors: Brian D
authors: BD
authors: Stein
authors: Jerry A
authors: JA
authors: Krishnan
mesh_terms: D000208:Acute Disease; D000328:Adult; D000402:Airway Obstruction / Q000209:etiology / Q000503:physiopathology*; D001249:Asthma / Q000150:complications / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D010351:Patient Discharge; D010465:Perception; D012720:Severity of Illness Index