Asthma among adult patients presenting with dyspnea to the emergency department: An observational study

Abstract

INTRODUCTION: Shortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes. OBJECTIVE: To describe the demographic features, clinical characteristics, management and outcomes of adults with an emergency department (ED) diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea. METHODS: Planned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study. AANZDEM was a prospective cohort study conducted in 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia over three 72-hour periods in May, August and October 2014. Primary outcomes were patient epidemiology, clinical features, treatment and outcomes (hospital length of stay (LOS) and mortality). RESULTS: Of the 3,044 patients with dyspnea, 387 (12.7%) had an ED diagnosis of asthma. The median age was 45 years, 60.1% were female, 16.1% were active or recent smokers, and 30.4% arrived by ambulance. Inhaled bronchodilator therapy was initiated in 88.1% of patients and 66.9% received both inhaled bronchodilators and systemic corticosteroids. After treatment in the ED, 65.4% were discharged. No death was reported. CONCLUSION: Asthma is common among patients presenting with a principal symptom of dyspnea in the ED of the Asia Pacific region. There was suboptimal adherence to international guidelines on investigations and treatments of acute asthma exacerbations presenting an opportunity to improve efficiency of care. This article is protected by copyright. All rights reserved.1752-699xKuan, Win Sen <br />ORCID: http://orcid.org/0000-0002-2134-7842 <br />Craig, Simon <br />Kelly, Anne-Maree <br />ORCID: http://orcid.org/0000-0002-4655-5023 <br />Keijzers, Gerben <br />Klim, Sharon <br />Graham, Colin A <br />Jones, Peter <br />Holdgate, Anna <br />Lawoko, Charles <br />Laribi, Said <br />Journal Article <br />England <br />Clin Respir J. 2018 Feb 22. doi: 10.1111/crj.12782. <br />