Incidence and Triggers of Asthma Exacerbations Attended in the Emergency Department as a Level of Care Indicator (ASMAB III, 2005 and ASMAB IV, 2011)

Abstract

Introduction: The identification of asthma exacerbations (AE) seen in emergency departments and in the home is proposed as a parameter of asthma control and for monitoring environmental triggers.

Patients and methods: All AEs seen in 2005 and 2011 in the reference hospital of the region and in the patients' homes by the Emergency Medical Services were identified.

Results: The incidence of AE was 1.93/10(6)inhabitants/day during 2005, and 2/10(6)inhabitants/day in 2011. The most common triggers were slow onset common cold of more than 24h duration in 104/219 (47%) AEs in 2005 and 107/220 (49%) in 2011; prior bronchial symptoms with cough, expectoration and fever were recorded in 41/219 (19%) in 2005 and in 57/220 (26%) AEs in 2011. In total, 49% (2005) and 74% (2011) of the AEs had onset more than 24h before admission.

Conclusions: No significant differences were observed in the rate of attendance in the emergency department due to AE between 2005 and 2011. The most common triggers were common cold and bronchial symptoms with expectoration and fever. AE had begun more than 24h previously in at least half of cases. These findings appear to suggest that there may be a scope for improvement in the outpatient care of the asthmatic patient.

Keywords: Agudizaciones asmáticas; Asthma epidemiology; Asthma exacerbations; Emergency services; Epidemiología del asma; Servicios de urgencias.