Long-term smoking increases the need for acute care among asthma patients: a case control study

BMC Pulm Med. 2014 Jul 16;14:119. doi: 10.1186/1471-2466-14-119.

Abstract

Background: To examine risk factors for asthma patients' emergency room (ER) visits in a well organized asthma care setting.

Methods: A random sample of 344 asthma patients from a Pulmonary Clinic of a University Hospital were followed through medical records from 1995 to 2006. All the ER visits due to dyspnea, respiratory infections, chest pain, and discomfort were evaluated.

Results: The mean age of the study population was 56 years (SD 13 years), 72% being women. 117 (34%) of the patients had had at least one ER visit during the follow-up (mean 0.5 emergency visits per patient year, range 0-7). Asthma exacerbation, lower and upper respiratory infections accounted for the 71% of the ER visits and 77% of the hospitalizations. The patients with ER visits were older, had suffered longer from asthma and more frequently from chronic sinusitis, were more often ex- or current smokers, and had lower lung function parameters compared to the patients without emergency visits. Previous (HR 1.9, CI 1.3-3.1) and current smoking (HR 3.6, CI 1.6-8.2), poor self-reported health related quality of life (HRQoL) (HR 2.5, CI 1.5-4), and poor lung function (FEV1<65%, HR 2.2, CI 1.3-3.7) remained independent risk factors for ER visits after adjustment for age and gender.

Conclusions: Asthma patients who are or have been long-term smokers are more likely to require ER care compared to never smokers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Asthma / complications*
  • Asthma / physiopathology
  • Chest Pain / etiology
  • Chronic Disease
  • Disease Progression
  • Dyspnea / etiology
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Forced Expiratory Volume
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Respiratory Tract Infections / etiology
  • Risk Factors
  • Sinusitis / complications
  • Smoking / adverse effects*
  • Time Factors