Asthma among adult patients presenting with dyspnea to the emergency department: An observational study

被引:3
作者
Kuan, Win Sen [1 ,2 ]
Craig, Simon [3 ,4 ,5 ]
Kelly, Anne-Maree [6 ,7 ]
Keijzers, Gerben [8 ,9 ,10 ]
Klim, Sharon [6 ]
Graham, Colin A. [11 ]
Jones, Peter [12 ,13 ]
Holdgate, Anna [14 ,15 ]
Lawoko, Charles [16 ]
Laribi, Said [17 ,18 ]
机构
[1] Natl Univ Hlth Syst, Natl Univ Hosp, Dept Emergency Med, Singapore, Singapore
[2] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Surg, Singapore, Singapore
[3] Monash Med Ctr, Emergency Dept, Clayton, Vic, Australia
[4] Monash Univ, Sch Clin Sci, Clayton, Vic, Australia
[5] Murdoch Childrens Res Inst, Parkville, Vic, Australia
[6] Joseph Epstein Ctr Emergency Med Res Western Hlth, Sunshine, Vic, Australia
[7] Univ Melbourne, Fac Med Dent & Hlth Sci, Parkville, Vic, Australia
[8] Gold Coast Univ Hosp, Dept Emergency Med, Gold Coast, Qld, Australia
[9] Bond Univ, Sch Med, Gold Coast, Qld, Australia
[10] Griffith Univ, Sch Med, Gold Coast, Qld, Australia
[11] Chinese Univ Hong Kong, Prince Wales Hosp, Shatin, Hong Kong, Peoples R China
[12] Auckland City Hosp, Dept Emergency Med, Auckland, New Zealand
[13] Univ Auckland, Dept Surg, Auckland, New Zealand
[14] Liverpool Hosp, Dept Emergency Med, Sydney, NSW, Australia
[15] Univ New South Wales, Southwest Clin Sch, Sydney, NSW, Australia
[16] ATN Univ, Ind Doctoral Training Ctr, Melbourne, Vic, Australia
[17] Francois Rabelais Univ, Sch Med, Tours, France
[18] Tours Univ Hosp, Dept Emergency Med, Tours, France
关键词
asthma; dyspnea; emergency services; epidemiology; hospital; EXACERBATIONS; MANAGEMENT; ASIA;
D O I
10.1111/crj.12782
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
IntroductionShortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes. ObjectiveThe aim of this study was to describe the demographic features, clinical characteristics, management and outcomes of adults with an ED diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea. MethodsPlanned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study. AANZDEM was a prospective cohort study conducted in 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia over three 72hour periods in May, August and October 2014. Primary outcomes were patient epidemiology, clinical features, treatment and outcomes (hospital length of stay (LOS) and mortality). ResultsOf the 3044 patients with dyspnea, 387 (12.7%) patients had an ED diagnosis of asthma. The median age was 45years, 60.1% were female, 16.1% were active or recent smokers and 30.4% arrived by ambulance. Inhaled bronchodilator therapy was initiated in 88.1% of patients, and 66.9% received both inhaled bronchodilators and systemic corticosteroids. After treatment in the ED, 65.4% were discharged. No death was reported. ConclusionAsthma is common among patients presenting with a principal symptom of dyspnea in the ED of the Asia Pacific region. There was a suboptimal adherence to international guidelines on investigations and treatments of acute asthma exacerbations presenting an opportunity to improve the efficiency of care.
引用
收藏
页码:2117 / 2125
页数:9
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