Indicators of hospitalization for patients with asthma crises

Abstract

INTRODUCTION: Asthma is a chronic respiratory condition in the airway that causes recurrent episodes
of wheezing, dyspnea, dry cough and pain or chest tightness. The lack of control of the disease increases
the risk of hospitalization, which is the main determining factor of health expenditure.
OBJECTIVE: Asses the clinical characteristics of patients that consult due to an acute asthma. Identify the
clinical parameters in the interrogation and the physical exam that predict hospitalization. Determine the
frequency of medical diagnosis of asthma in patients with recurrent crises of bronchospasms.
MATERIAL AND METHODS: Retrospective cross-sectional study, analytical. Population: 132 patients
over 18 years-old that consulted about coughing crises, dyspnea and wheezing at the emergency room of
the Clínica Universitaria Reina Fabiola. Descriptive statistics were used. For the comparison between
groups, the Mann-Whitney test or chi square test of independence was utilized. Stepwise multiple logistic
regression was carried out. The significance level used was 5%.
RESULTS: 132 patients who consulted about asthma crises were included. Most of the patients were
females, ranging between the ages of 37,9 ± 14,4 years-old. Of the total of the included patients, 48 (37%)
said to suffer a comorbidity, being rhinitis the most frequent one. It was observed that 83 (68,9%) patients
had self-medicated prior to their presentation at the hospital’s emergency room. In 11 (8,6%) patients,
hospitalization was advised, they were placed in regular rooms (only one of them required care in the
intensive care unit). 11 (8,7%) patients showed hypoxemia; however, the respiratory rate was the variable
in the physical exam associated with hospitalization (p<0.001), thereby increasing the probability of
hospitalization in values over 24rpm. There were no significant statistical differences between
hospitalization and the details related to the anamnesis.
CONCLUSIONS: No details were found in the anamnesis related to the hospitalization of the patient.
Regarding the variables linked to the physical exam, we were able to conclude that the respiratory rate was
the predicting variable of hospitalization, increasing the probability of hospitalization in patients with more
than 24rpm.