Abstract
Objectives: To describe the clinical course and predictors of poor outcome in patients with status asthmaticus at a tertiary care centre in Pakistan.
Methods: Data was collected in patients aged 16 and above with status asthmaticus on demographics, co-morbids, home medications, APACHE II score, use of mechanical ventilation, length of hospital stay, complications, and mortality.
Results: A total of 46 patients were studied, 40 (87%) were females. The mean age was 54±21 years. Ventilatory support was required in 34 (73.9%) patients, 17 (50%) required non invasive (BiPAP) ventilatory support, and 17 (50%) required invasive mechanical ventilation.
Hospital course was complicated by cardiac arrhythmias in 7 (15%) patients, sepsis in 5 (11%) and pneumothorax in 1 (2%) patient.
Three (6.5%) died, 2 due to sepsis and 1 due to respiratory failure. All three non-survivors were females and required invasive mechanical ventilation. Mean APACHE II score was 9.30±4.39 vs 13.66±2.08, mean PaCO2 was 53.83±23.07 mmHg vs 80.0±15.13 mmHg and arterial pH was 7.33±0.11 vs 7.21±0.09 among survivors and non survivors respectively.
Conclusion: Our study showed that requirement of ventilatory support was associated with prolonged hospital stay. High APACHE II scores, elevated PaCO2, and decreased arterial pH on admission were associated with increased mortality.
- © 2011 ERS