A territory‐wide study on the factors associated with recurrent asthma exacerbations requiring hospitalization in Hong Kong
Autor: | Fanny W.S. Ko, Yu Hong Chan, Kah Lin Choo, Ka Pang Chan, Chun Man Wong, Yi Tat Lo, Pik Shan Cheung, Pak Yiu Tse, Wai Kei Lam, Mo Lin Maureen Wong, Chung Tat Lun, Christopher Kei Wai Lai, Kwun Cheung Ling, Lee Veronica Chan, Sheng Sheng Ho, Macy Mei Sze Lui, Cee Zhung Steven Tseng, C K Ng, Kwok Sang Yee |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
Spirometry Adult Male medicine.medical_specialty asthma clinical care Immunology Rate ratio Atopy 03 medical and health sciences 0302 clinical medicine Interquartile range medicine Immunology and Allergy Humans Asthma Original Research Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Medical record Retrospective cohort study RC581-607 Middle Aged medicine.disease Comorbidity asthma (clinical aspects) asthma control Hospitalization 030104 developmental biology asthma exacerbations Emergency medicine Disease Progression asthma outcomes research Hong Kong Female Immunologic diseases. Allergy business 030215 immunology |
Zdroj: | Immunity, Inflammation and Disease Immunity, Inflammation and Disease, Vol 9, Iss 2, Pp 569-581 (2021) |
ISSN: | 2050-4527 |
Popis: | Background The real‐world relationships between the demographic and clinical characteristics of asthma patients, their prehospitalization management and the frequency of hospitalization due to asthma exacerbation is poorly established. Objective To determine the risk factors of recurrent asthma exacerbations requiring hospitalizations and evaluate the standard of baseline asthma care. Methods A territory‐wide, multicentre retrospective study in Hong Kong was performed. Medical records of patients aged ≥18 years admitted to 11 acute general hospitals from January 1 to December 31, 2016 for asthma exacerbations were reviewed. Results There were 2280 patients with 3154 admissions (36.7% male, median age 66.0 [interquartile range: 48.0–81.0] years, 519 had ≥2 admissions). Among them, 1830 (80.3%) had at least one asthma‐associated comorbidity, 1060 (46.5%) and 885 (38.9%) of patients had Accident and Emergency Department (AED) attendance and hospitalization in the preceding year, respectively. Patients with advancing age (incidence rate ratio [IRR]: 1.003 for every year increment), a history of AED visits or hospitalization (IRR: 1.018 and 1.070 for every additional episode, respectively) for asthma exacerbation in the preceding year, the presence of neuropsychiatric (IRR: 1.142) and gastrointestinal (IRR: 1.154) comorbidities were risk factors for an increasing number of admissions for asthma exacerbation. For patients with ≥2 admissions, 17.1% were not prescribed inhaled corticosteroid and only 44.6% had spirometry checked before the index admission. Asthma phenotyping was often incomplete, as assessment of atopy (total serum immunoglobulin E level and senitization to aeroallergens) was only performed in 30 (5.8%) patients with ≥2 admissions. Conclusions and Clinical Relevance Improving asthma care, especially in elderly patients with a prior history of urgent healthcare utilization and comorbidities, may help reduce healthcare burden. Suboptimal management before the index admission was common in patients hospitalized for asthma exacerbations. Early identification of patients at risk and enhancement of baseline asthma management may help to prevent recurrent asthma exacerbation and subsequent hospitalization. |
Databáze: | OpenAIRE |
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