Evaluation of Predictors of Admission in Asthmatic Patients in Emergency Department

Objective: To evaluate admission predictors in asthmatic patients who come to emergency department (ED) with asthma exacerbation. Background: Considering the increasing cases of asthmatic patients referring to ED we aimed to evaluate the factors effecting the prognosis and treatment to forecast the need for hospitalization or discharge. Material and methods: 103 asthmatic patients with acute exacerbation of asthma were enrolled in the study and went under treatment. Spirometry was done before and during treatment on the basis of GINA principles. Pulse oximetry, PImax, PEmax was done and documented at arrival and 30, 60, 120 minutes after arrival. Results: In admitted patients respiratory distress, intercostals retraction, function class (FC), pulse rate (PR), respiratory rate (RR), were significantly higher than discharged patients. Forced expiratory flow rate (FEV1%) (p<0.001), forced vital capacity (FVC) (p<0.001), FVC% (p<0.001), FEV1/FVC (p<0.001), peak expiratory flow rate (PEFR%) (p<0.001), saturation of peripheral oxygen SaO2 (p<0.001), maximal inspiratory pressure (PImax) (p<0.002) and maximal expiratory pressures (PEmax) (p<0.001) were significantly lower in admitted patients in comparison with discharged patients. Conclusion: In addition to FEV1 and PEF that have role in admission criteria, FEV1/FVC at arrival to ED and PEmax after an hour after treatment can also be used to forecast the need for admission.