Early prediction of poor outcome in patients with acute asthma in the emergency room

Autor: Francisco Juchem Machado, Eduardo Muller Ávila, Ana Maria Pasquali Steinhorst, Felipe Mallmann, Marcelo Gregorio Raymundi, Fernando Nogueira, Paulo de Tarso Roth Dalcin, Andreia Kist Fernandes, Dumitriu Zunino Saucedo, S.S. Menna Barreto
Jazyk: angličtina
Rok vydání: 2002
Předmět:
Male
Physiology
Biochemistry
Early prediction
Terapia intensiva
General Pharmacology
Toxicology and Pharmaceutics
Child
lcsh:QH301-705.5
Outcome
lcsh:R5-920
General Neuroscience
General Medicine
Middle Aged
Prognosis
Predictive value
Bronchodilator Agents
Respiratory Function Tests
Index score
Treatment Outcome
Anesthesia
Acute Disease
Emergency medicine
Female
lcsh:Medicine (General)
Emergency Service
Hospital
Adult
medicine.medical_specialty
Adolescent
Poor responder
Prognóstico
Immunology
Biophysics
Methylprednisolone
Sensitivity and Specificity
Statistics
Nonparametric
Predictive Value of Tests
medicine
Humans
In patient
Albuterol
Asma
Asthma
Pregnancy
Intravenous methylprednisolone
business.industry
Cell Biology
medicine.disease
Tratamento de emergência
Surgery
Estado asmático
Index
lcsh:Biology (General)
Multivariate Analysis
business
Follow-Up Studies
Zdroj: Brazilian Journal of Medical and Biological Research, Volume: 35, Issue: 1, Pages: 39-47, Published: JAN 2002
Brazilian Journal of Medical and Biological Research, Vol 35, Iss 1, Pp 39-47 (2002)
Repositório Institucional da UFRGS
Universidade Federal do Rio Grande do Sul (UFRGS)
instacron:UFRGS
Brazilian Journal of Medical and Biological Research v.35 n.1 2002
Brazilian Journal of Medical and Biological Research
Associação Brasileira de Divulgação Científica (ABDC)
instacron:ABDC
Popis: Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50% of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9%) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1%) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 hor =0% of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2.
Databáze: OpenAIRE
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