TY - JOUR
T1 - An Index Predicting Relapse and Need for Hospitalization in Patients with Acute Bronchial Asthma
AU - Fischl, Margaret A.
AU - Pitchenik, Arthur
AU - Gardner, Laurence B.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1981/10/1
Y1 - 1981/10/1
N2 - In an attempt to define guidelines for the assessment of acute asthma, we evaluated 205 patients who presented to the emergency room for treatment of asthma. Of the 205, 120 were successfully treated and discharged from the emergency room, 45 were hospitalized, and 40 were treated and discharged from the emergency room but had relapses within 10 days. A predictive index using a combination of presenting factors was developed: pulse rate ≥ 120 per minute, respiratory rate ≥ 30 per minute, pulses paradoxus ≥ 18 mm Hg, peak expiratory flow rate ≤ 120 liters per minute, moderate to severe dyspnea, accessory-muscle use, and wheezing. The index ranged from 0 to 7, increasing with the severity of symptoms. The index scores of the relapse group (4.9 ± 1.0) and the admitted group (5.1 ± 1.0) were both significantly different (P<0.001) from that of the successfully treated group (1.6 ± 1.2). An index of 4 or higher was 95 per cent accurate in predicting the risk of relapse and 96 per cent accurate in predicting the need for hospitalization.
AB - In an attempt to define guidelines for the assessment of acute asthma, we evaluated 205 patients who presented to the emergency room for treatment of asthma. Of the 205, 120 were successfully treated and discharged from the emergency room, 45 were hospitalized, and 40 were treated and discharged from the emergency room but had relapses within 10 days. A predictive index using a combination of presenting factors was developed: pulse rate ≥ 120 per minute, respiratory rate ≥ 30 per minute, pulses paradoxus ≥ 18 mm Hg, peak expiratory flow rate ≤ 120 liters per minute, moderate to severe dyspnea, accessory-muscle use, and wheezing. The index ranged from 0 to 7, increasing with the severity of symptoms. The index scores of the relapse group (4.9 ± 1.0) and the admitted group (5.1 ± 1.0) were both significantly different (P<0.001) from that of the successfully treated group (1.6 ± 1.2). An index of 4 or higher was 95 per cent accurate in predicting the risk of relapse and 96 per cent accurate in predicting the need for hospitalization.
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U2 - 10.1056/NEJM198110013051402
DO - 10.1056/NEJM198110013051402
M3 - Article
C2 - 7266631
AN - SCOPUS:0019485938
VL - 305
SP - 783
EP - 789
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 14
ER -