A study has been carried out on the incidence and clinical characteristics of asthma exacerbations (AE) seen in hospital accident and emergency departments (HA&ED) and domiciliary services (DS) in Barcelona.
Patients and methodsAEs were identified over a 56-day-period during the October and November 2003 and the patients seen in university hospitals were interviewed.
ResultsA total of 262 AE were identified, 188 in hospital accident and emergency departments and 82 in domiciliary care, which was a mean of 4.6 AE/day, giving an incidence of 0.37 AE/105 inhabitants. This incidence was no different from that obtained in the same months in 2002 (P > 0.05). The mean age (±standard deviation) of the143 cases of AE seen in university hospitals was 41±17 years; 87/143 (60%) were women and 57/138 (41%) smokers. In 36/61 (59%) the AE started in the home; in 88/132 (61%) it began 24 hours before arriving at the hospital centre. In 78/123 cases (63%) slow onset of nasal cold was noted before the AE and a viral infection was suspected. Inhaled corticosteroids were administered to 45/112 patients (40%), and only one was also given oral corticosteroids 12 hours before admission. The AEs were mild in 38/75 cases (51%), moderate in 28/75 (37%), severe in 8/75 (11%) and almost fatal in one patient (1.3%). Around 10% (13/137) of patients (10%) were readmitted.
ConclusionsThe daily incidence of AE is 0.37/105 inhabitants. More than half of the exacerbations started after nasal cold and 11% of the AEs were severe.
Se ha estudiado la tasa de agudizaciones asmáticas (AA) atendidas en los servicios de urgencias hospitalarios (SUH) y domiciliarios (SEM), así como sus características clínicas.
Pacientes y métodosDurante los meses de octubre y noviembre de 2003 se identificaron durante 56 días las AA y se entrevistó a los pacientes atendidos en los hospitales universitarios.
ResultadosSe identificaron 262 AA, 188 en los servicios de urgencias hospitalarios y 82 en los domiciliarios, es decir, una media de 4,6 AA/día, lo que significa una tasa de 0,37 AA/105 habitantes, incidencia no diferente de la obtenida en los mismos meses de 2002 (p > 0,05). La edad media (± desviación estándar) de los 143 casos de AA atendidas en los hospitales universitarios era de 41 ± 17 años; 87/143 (60%) eran mujeres y 57/138 (41%), fumadores. En 36/61 (59%) la AA se inició en el domicilio; en 88/132 (61%) comenzó 24 h antes de la llegada al centro hospitalario. En 78/123 casos (63%) se registró catarro nasal de instauración lenta antes de la AA y se sospechó una infección vírica. Recibían corticosteroides inhalados 45/112 pacientes (40%), y únicamente uno añadió corticosteroides orales en las 12h previas al ingreso. La AA era leve en 38/75 casos (51%), moderada en 28/75 (37%), grave en 8/75 (11%) y casi fatal en un paciente (1,3%). Fueron readmitidos 13/137 pacientes (10%).
ConclusionesLa incidencia diaria de AA es de 0,37/105 habitantes. Más de la mitad de las agudizaciones se habían iniciado tras un catarro nasal. Un 11% de las AA eran graves.
