[The epidemiology and management of an acute asthmatic attack]

The mortality rate for acute asthma increased approximately 40% between 1982 and 1991 in the United States, while hospital admissions remained constant. In order to verify if inadequate therapy at home could increase hospitalization for this pathology, we evaluated retrospectively 94 subjects admitted to the Emergency Department of Rho Hospital, near Milan (Italy), for acute asthma in 1996. We studied the correlations between some epidemiological variables (sex and age) and the hospitalization of asthmatic patients and described the different therapeutic approaches at home and in the Emergency Department. Our data show that subjects > 40 years old, mostly females, were admitted more frequently than younger patients (38%) (p < 0.03). In comparison with the international guidelines we document the underuse of inhaled corticosteroids (69.7%) previous to the acute attack (p < 0.01). In conclusion, we believe that the correct early use of inhaled corticosteroids at home could prevent hospitalization for asthma, particularly in the elderly.