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

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

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Título Early prediction of poor outcome in patients with acute asthma in the emergency room
Autor Mallmann, Felipe
Fernandes, E. M.
Ávila, Eduardo Muller
Nogueira, Fernando Lopes
Steinhorst, Ana Maria Pasquali
Saucedo, Dumitriu Zunino
Machado, Francisco Juchem
Raymundi, Marcelo Gregorio
Dalcin, Paulo de Tarso Roth
Menna Barreto, Sérgio Saldanha
Abstract 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 h £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.
Contido em Brazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 35, no. 1 (Jan. 2002), p. 39-47
Assunto Asma
Estado asmático
Prognóstico
Terapia intensiva
Tratamento de emergência
[en] Asthma
[en] Emergency medicine
[en] Index
[en] Outcome
[en] Prognosis
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/21118
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