Relationship between the characteristics of hospitalised acute asthma patients and the severity of their asthma. A case-control study.
BACKGROUND
The EAGLE project database was analysed to assess the characteristics of patients with severe (SA) who required hospitalisation as a result of an acute episode during the period 1994-2004, and the relationship with asthma severity.


METHODS
A total od 2593 clinical records corresponding to an equal number of patients hospitalised for acute asthma (15-69 years), with sufficient information to characterize their asthma severity in agreement with GNA criteria were identified (727 patients with SA compared with 1866 patients with non-severe asthma).


RESULTS
Patients with SA were older, displayed a greater predominance of female asthmatics, lower antecedents of atopy, and a higher frequency of previous hospitalisations compared with non-severe asthmatics (86.1% vs. 50.5%, p< or = 0.01). Additionally, SA patients showed more severe exacerbations characterized by acidosis, significant spirometric deterioration, greater length of hospital stay (9.4 days vs. 7.0 days), as well as a higher frequency of intubation (16.8% vs. 2.1%), intensive care unit admission (11.3% vs.4.9%), cardiopulmonary arrest (5.5% vs. 1.3%), and asthma deaths (2.1% vs. 0.4%) (all < or = 0.01) compared wit non-severe patients.


CONCLUSIONS
This study suggests that SA patients have greater morbidity and a disproportionate need for health care as a result of more severe exacerbations. However, non-severe asthmatics can also still present acute severe episodes (although with a lower frequency) with risk of life.
Rodrigo
G J
GJ
Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay. gurodrig@adinet.com.uy
Plaza
V
V
Neffen
H
H
Levy
G
G
Perpiñá
M
M
D000142:Acidosis, Respiratory; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology* / Q000628:therapy; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006323:Heart Arrest; D006760:Hospitalization; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D013030:Spain; D013147:Spirometry; D016019:Survival Analysis
D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents