Characteristics of Asthma Exacerbations in the Emergency Department at a Tertiary Hospital

Rationale: There are few studies in Spain describing the clinical profile of asthmatic patients with asthma exacerbations attending the Emergency Department. Identifying the risk factors, recognizing severity signs and starting an adequate and prompt treatment are essential tools to improve asthma control. 

Methods: We included all patients aged 18 years or older who were attended during the year 2014 in the Emergency Department of our hospital due to an asthma exacerbation. We performed an epidemiological, retrospective, open and observational study. 

Results: A total of 831 patients were included, with a mean age of 57 years, 67.7% were women, and 18% were active smokers. Higher number of asthma exacerbations were observed in January and May due to respiratory infections and exposure to seasonal allergens (pollen), respectively. 43% of the patients did not have a previous diagnosis of asthma. Of the already diagnosed asthmatic patients 10% were not receiving any treatment and 13% had suffered an exacerbation the previous year. Of the study patients, 32% patients required hospital ward admission, 6 required admission into the intensive care unit and 3 patients died. 54 patients presented a relapse of the exacerbation during the following fifteen days.  In our patients, blood eosinophilia was associated to higher rate of  hospital admission.

Conclusions: Asthmatic exacerbations are still a frequent cause of urgent medical assistance in the Emergency Department. Many patients do not receive any therapy regularly. The hospital ward admission rate is high, 32% of patients could not be controlled with treatment in the Emergency Department.