Prediction of relapse within eight weeks after an acute asthma exacerbation in adults

Madeline McCarren*, Michael F. McDermott, Robert J. Zalenski, Borko Jovanovic, David Marder, Daniel G. Murphy, Linda M. Kampe, Virginia M. Misiewicz, Robert J. Rydman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)107-118
Number of pages12
JournalJournal of Clinical Epidemiology
Volume51
Issue number2
DOIs
StatePublished - Feb 1 1998

Keywords

  • Adult
  • Asthma
  • Emergency medicine
  • Outcomes
  • Prognosis
  • Relapse

ASJC Scopus subject areas

  • Epidemiology

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