Early prediction of poor outcome in patients with acute asthma in the emergency room

Mallmann, Felipe; Fernandes, Andreia Kist; Avila, Eduardo; Nogueira, Fernando Lopes; Steinhorst, Ana Maria Pasquali; Saucedo, Dumitriu Zunino; Machado, Francisco Juchem; Raymundi, Marcelo Gregorio; Dalcin, Paulo de Tarso Roth; Barreto, S.S. Menna

doi:10.1590/s0100-879x2002000100006

Cited by 11 publications

(10 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(29) 41.5% presenting symptoms in the first year of life. Only 21.5% of the patients were under prophylactic therapy when the evaluation was carried out, and 43.1% had been previously hospitalized.…”

Section: Resultsmentioning

confidence: 99%

“…(4,29) However, one study showed that baseline PEF, as well as baseline SpO 2 , was not useful for identifying the children who would be hospitalized. (8) In another study, baseline PEF was found to be an accurate indicator of which children would be hospitalized but not of which would be discharged and later suffer recurrence of acute asthma symptoms.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fatores preditivos da evolução da asma aguda em crianças

Paro

Rodrigues

2005

J. bras. pneumol.

View full text Add to dashboard Cite

Objective: To use clinical and functional characteristics observed upon admission to an emergency room to identify factors predictive of the occurrence and course of acute asthma attacks in children. Methods: We prospectively studied 130 asthmatic children, from 1 to 13 years of age, who were treated for acute asthma attacks in an emergency room, evaluating status determined at admission and over the course of the crisis. Clinical scores were determined and arterial oxygen saturation by pulse oximetry was measured, as was peak expiratory flow. Results: The initial clinical score, arterial oxygen saturation by pulse oximetry and peak expiratory flow correlated with the number of inhalations performed, as well as with the need for corticosteroid treatment. Mean initial clinical score and mean arterial oxygen saturation by pulse oximetry of the hospitalized patients were statistically different from those of patients who were not hospitalized. Initial clinical score, arterial oxygen saturation and prior treatment for the same exacerbation were predictive of the need for hospitalization. Conclusion: The measurement of arterial oxygen saturation by pulse oximetry and the clinical score were useful in predicting the occurrence and course of acute asthma attacks in children. The measurement and interpretation of peak expiratory flow is difficult in children and, under these conditions, served no practical application.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fatores preditivos da evolução da asma aguda em crianças

Paro

Rodrigues

2005

J. bras. pneumol.

View full text Add to dashboard Cite

show abstract

“…However, a previous study (14) showed that only 13% of the patients who appeared at the adult ED of our Hospital with an asthma attack had a forced expiratory volume in the 1st minute (FEV 1 ) above 50% of the predicted value. Thus, we believe that most of the patients attending our ED are subjects with moderate to severe acute asthma.…”

Section: Statusmentioning

confidence: 87%

Factors associated with emergency department visits due to acute asthma

Dalcin

Piovesan

Kang

et al. 2004

Braz J Med Biol Res

Self Cite

View full text Add to dashboard Cite

It is important to identify characteristics related to poor disease control and frequent visits to the emergency department (ED). The objective of the present study was to compare the characteristics of patients attending the adult ED for treatment of asthma exacerbation with those attending an asthma specialist clinic (AC) in the same hospital, and to determine the factors associated with frequent visits to the ED. We conducted a cross-sectional survey of consecutive patients (12 years and older) attending the ED (N = 86) and the AC (N = 86). Significantly more ED patients than AC patients reported ED visits in the past year (95.3 vs 48.8%; P < 0.001) and had difficulty performing work (81.4 vs 49.4%; P < 0.001. Significantly more AC than ED patents had been treated with inhaled corticosteroids (75.6 vs 18.6%; P < 0.001) used to increase or start steroid therapy when an attack was perceived (46.5 vs 20.9%; P < 0.001) and correctly used a metered-dose inhaler (50.0 vs 11.6%; P < 0.001). The history of hospital admissions (odds ratio, OR, 4.00) and use of inhaled corticosteroids (OR, 0.27) were associated with frequent visits to the ED. In conclusion, ED patients were more likely than AC patients to be dependent on the acute use of the ED, were significantly less knowledgeable about asthma management and were more likely to suffer more severe disease. ED patients should be considered an important target for asthma education. Facilitating the access to ambulatory care facilities might serve to reduce asthma morbidity.

show abstract

“…We found that oxygen flow rate predicted need for critical care, presumably reflecting that flow rate is a better predictor than saturation when treatment involves titration of oxygen flow rate to achieve target oxygen saturation. Mallmann et al 9 and Rodrigo and Rodrigo15 reported that accessory muscle use predicted need for hospital admission, while Boonsarngsuk et al 8 and Wilson et al 10 reported that the inability to lie flat were predictive of hospital admission or relapse. We did not test these variables in our analysis.…”

Section: Discussionmentioning

confidence: 99%