1. Prediction of relapse within eight weeks after an acute asthma exacerbation in adults.
- Author
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McCarren M, McDermott MF, Zalenski RJ, Jovanovic B, Marder D, Murphy DG, Kampe LM, Misiewicz VM, and Rydman RJ
- Subjects
- Acute Disease, Adult, Asthma drug therapy, Cohort Studies, Disease-Free Survival, Female, Humans, Illinois, Male, Middle Aged, Multivariate Analysis, Prognosis, Prospective Studies, Recurrence, Risk Factors, Time Factors, Asthma diagnosis
- Abstract
Associations between historical, presenting, and treatment-related characteristics and relapse within 8 weeks after a moderate to severe asthma exacerbation were studied in a cohort of 284 adult asthmatics. Data were collected prospectively, and a multivariate model was developed and internally validated. Within 10 days, only 8% had relapsed, increasing to 45% by 8 weeks. Three variables that could be identified at the time of discharge were independently associated with relapse. These included: having made three or more visits to an emergency department in the prior 6 months (hazard ratio (HR) = 2.3, 95% CI = 1.6-3.4); difficulty performing work or activities as a result of physical health in the 4 weeks prior (HR = 2.7, 95% CI = 1.6-4.3); discontinuing hospital-based treatment for the exacerbation within 24 hours without having achieved a peak expiratory flow rate of at least 50% of predicted (HR = 2.6, 95% CI = 1.6-4.1). These risk factors may help to identify patients with poorly controlled asthma in need of more intensive and comprehensive management.
- Published
- 1998
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