Failure of peak expiratory flow rate to predict hospital admission in acute asthma

Our study evaluated the ability of early peak expiratory flow rates (PEFR) to be predictive of hospital admission while double blinding the measurements and using a standardized treatment protocol and specific admission criteria. The measurements were recorded prior to and after initial therapy. Eighty-six acute asthmatic episodes in 51 patients were analyzed. Nine (10.5%) of the episodes resulted in hospitalization; 77 (89.5%) resulted in discharge. No correlation with admission was found for the initial PEFR, a second PEFR following treatment, or the differences between these two values. Our study indicates that early PEFRs alone are not useful predictors of the need for hospital admission. Although a significant number of patients in our study population presented with severe airflow obstruction, they responded sufficiently to treatment to permit discharge.