본문 바로가기
KERD
논문KCI 등재

중증 천식발작 회복 후 임상 경과 - 제3보

Clinical outcomes after recovery from severe asthma exacerbation - the third report

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류소아과학

초록

Purpose: Up to 10% of the mortality rate of asthmatics within a year from the near-fatal attacks has been reported. We previously reported that not a few patients with acute severe asthma died after discharge from the hospital. This study investigated whether our efforts to improve clinical outcomes of patients after recovery from severe asthma exacerbation did work or not. Methods: Follow-up data from asthmatic patients who had been hospitalized due to severe exacerbation between 2007 and 2014 (present) were compared with that the previous one (1998–2006) (previous). Results: Sex, age, near-fatal asthma, and mortality (9.8% vs. 9.6%) were not significantly different between the previous (n=225) and present (n=397) studies. However, rehospitalization rate was significantly lower in the present study (29.3% vs. 52.4%, P=0.000). The patients in the present study used inhaled steroid more frequently (78.5% vs. 68.0%, P=0.006), had better asthma knowledge (P=0.000), and higher proportion of regular hospital visitors to total subjects (75.6% vs. 64.9%, P=0.004) than did the previous patients. The regular hospital visitors (n=300) showed a significantly lower mortality (3.3% vs. 28.9%, P=0.000), better knowledge (P=0.000) and higher inhaled steroid use (85.8% vs. 54.1%, P=0.000) than did the other group (n=97) in the present study. Conclusion: Clinical outcomes after recovery from severe asthma exacerbation in the present study were better than the previous one. Our efforts to educate patients might contribute to these better results.

Abstract

Purpose: Up to 10% of the mortality rate of asthmatics within a year from the near-fatal attacks has been reported. We previously reported that not a few patients with acute severe asthma died after discharge from the hospital. This study investigated whether our efforts to improve clinical outcomes of patients after recovery from severe asthma exacerbation did work or not. Methods: Follow-up data from asthmatic patients who had been hospitalized due to severe exacerbation between 2007 and 2014 (present) were compared with that the previous one (1998–2006) (previous). Results: Sex, age, near-fatal asthma, and mortality (9.8% vs. 9.6%) were not significantly different between the previous (n=225) and present (n=397) studies. However, rehospitalization rate was significantly lower in the present study (29.3% vs. 52.4%, P=0.000). The patients in the present study used inhaled steroid more frequently (78.5% vs. 68.0%, P=0.006), had better asthma knowledge (P=0.000), and higher proportion of regular hospital visitors to total subjects (75.6% vs. 64.9%, P=0.004) than did the previous patients. The regular hospital visitors (n=300) showed a significantly lower mortality (3.3% vs. 28.9%, P=0.000), better knowledge (P=0.000) and higher inhaled steroid use (85.8% vs. 54.1%, P=0.000) than did the other group (n=97) in the present study. Conclusion: Clinical outcomes after recovery from severe asthma exacerbation in the present study were better than the previous one. Our efforts to educate patients might contribute to these better results.

참고문헌 (22)

  1. Marquette CH, "Long-term prognosis of near-fatal asthma. A 6-year follow-up study of 145 asthmatic patients who underwent mechanical ventilation for a near-fatal attack of asthma", Am Rev Respir Dis, 146, pp.76~81 (1992)
  2. Ulrik CS, "The patient's perspective: adherence or non-adherence to asthma controller therapy?", J Asthma, 43, pp.701~704 (2006)
  3. Barnes PJ, "Harrison’s principles of internal medicine", pp.1669~1681 (2015), McGraw-Hill Education
  4. Kikuchi Y, "Chemosensitivity and perception of dyspnea in patients with a history of near-fatal asthma", N Engl J Med, 330, pp.1329~1334 (1994)
  5. Jang AS, "Increased perception of dyspnea by inhalation of short acting beta2 agonist in patients with asthma of varying severity", Ann Allergy Asthma Immunol, 84, pp.79~83 (2000)
  6. Molfino NA, "The fatality-prone asthmatic patient. Follow-up study after near-fatal attacks", Chest, 101, pp.621~623 (1992)
  7. 정해영, "중증 천식발작 회복 후 임상경과 - 제2보", 천식 및 알레르기, 29(1), pp.27~32 (2009), 대한천식알레르기학회
  8. 권성신, "중증 급성 천식 악화로 중환자실에 입원한 환자의 사망위험 요인", Allergy Asthma & Respiratory Diseases, 3(6), pp.432~438 (2015), 대한 소아알레르기 호흡기학회[DOI]
  9. "British guideline on the management of asthma: a national clinical guideline" (2012)[URL]
  10. Choi IS, "Risk factors of near - fatal asthma", Korean J Med, 57, pp.52~59 (1999)
  11. Crapo RO, "Reference spirometric values using techniques and equipment that meet ATS recommendations", Am Rev Respir Dis, 123, pp.659~664 (1981)
  12. "Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute. National Asthma Education Program. Expert Panel Report", J Allergy Clin Immunol, 88(3 Pt 2), pp.425~534 (1991)
  13. Bai TR, "The effect of age and duration of disease on airway structure in fatal asthma", Am J Respir Crit Care Med, 162(2 Pt 1), pp.663~669 (2000)
  14. Wennergren G, "Decrease in hospitalization for treatment of childhood asthma with increased use of antiinflammatory treatment, despite an increase in prevalence of asthma", J Allergy Clin Immunol, 97, pp.742~748 (1996)
  15. Donahue JG, "Inhaled steroids and the risk of hospitalization for asthma", JAMA, 277, pp.887~891 (1997)
  16. Jónasson G, "Trends in hospital admissions for childhood asthma in Oslo, Norway, 1980-95", Allergy, 55, pp.232~239 (2000)
  17. Suissa S, "Low-dose inhaled corticosteroids and the prevention of death from asthma", N Engl J Med, 343, pp.332~336 (2000)
  18. Thomson NC, "Asthma and cigarette smoking", Eur Respir J, 24, pp.822~833 (2004)
  19. Kauppi P, "Overlap syndrome of asthma and COPD predicts low quality of life", J Asthma, 48, pp.279~285 (2011)
  20. Taylor DM, "Current outpatient management of asthma shows poor compliance with International Consensus Guidelines", Chest, 116, pp.1638~1645 (1999)
  21. George MR, "A comprehensive educational program improves clinical outcome measures in inner-city patients with asthma", Arch Intern Med, 159, pp.1710~1716 (1999)
  22. 최인선, "Gender-Specific Asthma Treatment", Allergy, Asthma & Immunology Research, 3(2), pp.74~80 (2011), 대한천식알레르기학회

관련 논문AI추천

이 간행물의 다른 논문 (11건)