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.

AEs were identified over a 56-day-period during the October and November 2003 and the patients seen in university hospitals were interviewed.

A 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.

The 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.

Durante 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.

Se 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%).

La 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.