Analysis of the Characteristics of Patients Presenting with Exacerbation of Asthma to Emergency Care Units

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Background:Fatal asthma remains a serious problem, and patient self-management of asthma is important to prevent exacerbation. To reduce the asthma mortality rate, we analyzed the characteristics of patients who visited an emergency care unit with exacerbation of asthma.Methods:Subjects were 317 patients(135 men, 182 women;mean age, 47.0 years)who visited the emergency room at Dokkyo Medical University Hospital or Dokkyo Medical University Koshigaya Hospital for exacerbation of asthma between April 2010 and March 2011. When categorized by severity, 41.3% ofpatients were step 1, 8.2% were step 2, 18.9% were step 3, 30.9% were step 4, and 0.6% were unknown. When categorized by primary care physician, 60.3% of patients had a primary care physician at Dokkyo Medical University, 13.6% had one at another hospital, and 26.2% had no primary care physician. When categorized by recovery from exacerbation, control was achieved within 1 day in 63.1% of cases, after more than 1 day in 30.6% of cases, and required admission in 6.3% of cases.Results:The rate of admissions was highest for cases with step 1 severity(step 1, 55.0%;step 2, 20.0%;step 3, 0.0%;and step 4, 25.0%). The rate of admissions did not differ significantly by age(age 15-39 years, 40.0%;40-65 years, 25.0%;>65 years, 35.0%). Initial value of oxyhemoglobin saturation(SpO_2) measured by pulse oximetry was significantly lower in the admission group(SpO_2 92.4%)than in the nonadmissiongroup(SpO_2 95.2%, p<0.01).Conclusion:Patients with step 1 severity who visit an emergency unit with exacerbation of asthma may need regular treatment for asthma. When initial SpO_2 is less than 92%, we should consider hospitalization for treatment of asthma.

identifier:3

identifier:KJ00009786640

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