Introduction: A study has been made on the incidence and clinical characteristics of asthma exacerbations (AE) seen in hospital emergency departments (HED) and domiciliary services (DS) in Barcelona.
Patients and methods: AEs were identified over a 56 day period during the months of October and November 2003 and the patients seen in university hospitals were interviewed.
Results: A total of 262 AE were identified, 188 in hospital emergency departments and 82 in domiciliary, which was a mean of 4.6 AE/day, giving an incidence of 0.37 AA/10(5) inhabitants. This incidence was no different from that obtained in the same months in 2002 (P>0.05). The mean age (+/-standard deviation) of the 143 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 catarrh was noted before the AE and a viral infection was suspected. Inhaled corticoids were given to 45/112 patients (40%), and only one added oral corticoids 12 hours before admission. The AE 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 re-admitted.
Conclusions: The daily incidence of AE is 0.37/10(5) inhabitants. More than half of the exacerbations started after nasal catarrh and 11% of the AE were severe.