An index predicting relapse and need for hospitalization in patients with acute bronchial asthma

Margaret A Fischl, A. Pitchenik, L. B. Gardner

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)783-789
Number of pages7
JournalNew England Journal of Medicine
Volume305
Issue number14
StatePublished - Jan 1 1981

Fingerprint

Hospital Emergency Service
Hospitalization
Asthma
Recurrence
Peak Expiratory Flow Rate
Emergency Treatment
Respiratory Sounds
Respiratory Rate
Dyspnea
Heart Rate
Guidelines
Muscles
1-O-decylpropanediyl-3-phosphorylcholine

ASJC Scopus subject areas

  • Medicine(all)

Cite this

An index predicting relapse and need for hospitalization in patients with acute bronchial asthma. / Fischl, Margaret A; Pitchenik, A.; Gardner, L. B.

In: New England Journal of Medicine, Vol. 305, No. 14, 01.01.1981, p. 783-789.

Research output: Contribution to journalArticle

@article{98549cbb6cb840e48f932928aa522519,
title = "An index predicting relapse and need for hospitalization in patients with acute bronchial asthma",
abstract = "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.",
author = "Fischl, {Margaret A} and A. Pitchenik and Gardner, {L. B.}",
year = "1981",
month = "1",
day = "1",
language = "English",
volume = "305",
pages = "783--789",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "14",

}

TY - JOUR

T1 - An index predicting relapse and need for hospitalization in patients with acute bronchial asthma

AU - Fischl, Margaret A

AU - Pitchenik, A.

AU - Gardner, L. B.

PY - 1981/1/1

Y1 - 1981/1/1

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.

UR - http://www.scopus.com/inward/record.url?scp=0019485938&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0019485938&partnerID=8YFLogxK

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 -