Chest
Clinical Investigations: AsthmaHealth-Care Utilization After Near-Fatal Asthma
Section snippets
Methods
We examined all medical records from The Toronto Hospital from 1981 to 1986 where patients’ admitting diagnosis was recorded as asthma. A trained research assistant reviewed the entire hospital chart of each patient and excluded the chart from the analysis if (1) there was a second admitting diagnosis, ie, congestive heart failure, (2) the diagnosis of asthma was unclear, or (3) there was a second respiratory diagnosis, ie, pneumonia, COPD. Charts were excluded if the discharge diagnosis did
Patient Characteristics
A total of 101 cases of near-fatal asthma were identified through hospital records using the preset criteria. Thirty-seven patients consented to participate in the study. There was a mean of 6.76 ± 1.4 years between the near-fatal admission and the time of the present study. Forty-six percent of the subjects had been intubated. The mean age of the near-fatal cases intubated and those not intubated was 40.9 ± 17.6 and 38.45 ± 14.3 years respectively. The man to woman ratio was 7:10 for those
Discussion
Near-fatal asthma, as defined by the occurrence of an elevated PaCO2 of at least 45 mm Hg or intubation, has been associated with an increased risk of death from asthma.5, 6, 9, 10 We sought to examine the long-term use of health-care services by patients who experience near-fatal asthma but do not die from their disorder. Demographic data such as place of birth, level of education, marital status, or occupation did not distinguish patients who survived over a prolonged period after a
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Cited by (16)
The influence of perceived control of asthma on health outcomes
2006, ChestCitation Excerpt :To establish a cohort with more severe asthma,8,910,11,12 we recruited adults after hospitalization for asthma using a previously established algorithm.13 Beginning in April 2000, we attempted to recruit all eligible adults who were admitted to the ICU for asthma and were therefore considered to have more severe asthma.8,1415,16,17 To broaden the spectrum of asthma severity, we also began recruiting a random sample of all eligible adults who were hospitalized for asthma in September 2000; in October 2002, we began recruiting all eligible adults who had been hospitalized for asthma.
Risk Factors for Work Disability in Severe Adult Asthma
2006, American Journal of MedicineCitation Excerpt :A combined clinical approach that includes smoking cessation, a careful occupational history, and optimization of asthma therapy has the potential to prevent work loss, financial deterioration, and negative asthma health outcomes.24-27
Asthma-related healthcare services utilization by African-Americans enrolled in West Virginia Medicaid
2006, Respiratory MedicineEpidemiology of respiratory viruses in patients hospitalized with near-fatal asthma, acute exacerbations of asthma, or chronic obstructive pulmonary disease
2003, American Journal of MedicineCitation Excerpt :In addition, patients hospitalized with acute exacerbations of COPD were significantly older than asthmatic patients. It is unclear whether these differences could be due to possible age- and sex-based susceptibilities for viral infection and type of exacerbation, differences in the natural history of the asthmatic attack (21–23), or perhaps differences in hospitalization (24–28) or health care utilization (29). Another limitation is that we combined groups of viruses (picornavirus and adenovirus, and influenza A and B viruses) in the data analysis; these were not prespecified hypotheses.
Near-fatal asthma: A population-based study of risk factors
2002, ChestCitation Excerpt :Effective treatment is likely to improve their quality of life and to allow participation in, for example, sports. Given their subsequent use of health-care resources,31 such an approach may reduce costs. However, there is considerable overlap in the risk factors among the three groups.
Potentially fatal asthma and asthma deaths: Knowledge is greater but implementation appears problematic
2000, Annals of Allergy, Asthma and Immunology
revision accepted October 14.