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Admissions to Canadian hospitals for acute asthma: a prospective, multicentre study
B H Rowe1, C Villa-Roel, R B Abu-Laban
1University of Alberta, Edmonton, Alberta, Canada. brian.rowe@ualberta.ca
Canadian Respiratory Journal
|February 27, 2010
Summary
This study identified key factors predicting hospital admission for acute asthma in Canadian emergency departments (EDs). Older age, prior admissions, and specific symptom severity markers significantly influenced ED admission decisions for asthma patients.
Area of Science:
- Emergency Medicine
- Pulmonology
- Clinical Epidemiology
Background:
- Asthma exacerbations are a leading cause for emergency department (ED) visits globally.
- Hospitalization rates for severe asthma vary, indicating potential inconsistencies in ED admission practices.
Purpose of the Study:
- To identify factors associated with hospital admission for acute asthma following emergency department treatment in Canada.
- To provide insights into clinical decision-making for acute asthma admissions.
Main Methods:
- Prospective study involving 695 adult patients (18-55 years) treated for acute asthma across 20 Canadian EDs.
- Data collected via structured ED interviews and follow-up telephone interviews two weeks later.
Main Results:
- The overall admission rate was 13.1%.
- Admitted patients were older, more likely to be on corticosteroids, and received more intensive ED treatments (e.g., systemic corticosteroids, magnesium sulfate).
- Multivariable analysis revealed age, prior admissions, high beta-2 agonist use, severe triage score (1-2), elevated respiratory rate (>22/min), and low oxygen saturation (<95%) as significant predictors of admission.
Conclusions:
- Canadian EDs had a lower acute asthma admission rate compared to other North American studies.
- Clinical history and objective markers of asthma severity are crucial for ED admission decisions.
- Standardizing ED management and streamlining admission processes are recommended.
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