| Autor: |
Willert, Craig, Davis, A Todd, Herman, James J, Holson, Brenda B, Zieserl, Edward |
| Zdroj: |
Pediatric Research; April 1984, Vol. 18 Issue: 1, Number 1 Supplement 4 p389A-389A, 1p |
| Abstrakt: |
Status asthmaticus (SA) exacts a heavy toll on hospital resources and family finances. We undertook a randomized trial to determine if short-term treatment in a Holding Room (HR), compared to hospitalization, was safe, effective, and resulted in cost savings. Patients with SA after emergency room therapy with SQ epinephrine and bolus IV aminophylline and saline were eligible for study. 51 patients were hospitalized and 52 assigned to the HR. The groups were comparable in 36/37 medical, pretreatment and treatment variables. Two-thirds of the HR patients were discharged within 24 hours (mean 11.8hr). The other 1/3 required hospitalization. One-third of hospitalized patients received <1 day of IV therapy and 2/3 received <2 days of IV therapy (mean 45.6hr). HR patients were discharged immediately upon cessation of wheezing. Many hospitalized patients received 1 more day of inhospital oral theophylline to ensure adequate serum concentrations. There were no statistically significant differences in recurrence rates between the 2 groups in the 28 days following SA. Medical costs were compared in those patients who received <1 day of IV therapy and had no recurrent episodes. The mean cost for HR therapy was $550±226 and $1,464±339 for hospitalized patients (p<.0001). We conclude: a) HR treatment of SA is as safe and effective as hospitalization; b) HR therapy is much less costly than hospitalization; and c) hospitalized patients need not be held for an additional 12-24 hours to determine serum concentrations while receiving oral theophylline. |
| Databáze: |
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