반복 입원 천식환자에서 호흡곤란 인지능의 변화
Variation of Dyspnea Perception in Repeatedly Hospitalized Patients with Asthma
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Background: Anti-asthma treatments correct impaired dyspnea perception. Objective: To investigate whether dyspnea perception in asthmatics vary whenever they are hospitalized. Method: We retrospectively analyzed the medical records of 64 patients (32 men and 32 women) with acute asthma who were hospitalized at least twice and assessed using the Borg scale-based dyspnea perception score while breathing through an inspiratory muscle trainer at each admission. Poor perceiver was defined as a Borg score of ≤5 at the highest resistive load (HR) and HR-induced ΔBorg score of ≤3. Result: Between the first and second admissions, the relationship of forced expiratory volume in 1 s (r=0.773, P ＜0.001) and the concordance of severity of asthma attack (κ=0.503, P＜0.001) were significant, but the relationship of HR-induced ΔBorg score and the concordance of poor perceivers were not. During the first admission, as lung function increased gradually, the HR-induced ΔBorg score became higher in poor perceivers (1.83±0.39→3.42±0.57→4.00±0.67, P=0.048). Conclusion: Although asthmatic patients who suffered from a severe asthma attack tended to have a severe attack again at the following admission, dyspnea perception differs among the admissions. Impaired dyspnea perception during acute asthmatic attack would be correctable with anti-asthma treatments.
Abstract
Background: Anti-asthma treatments correct impaired dyspnea perception. Objective: To investigate whether dyspnea perception in asthmatics vary whenever they are hospitalized. Method: We retrospectively analyzed the medical records of 64 patients (32 men and 32 women) with acute asthma who were hospitalized at least twice and assessed using the Borg scale-based dyspnea perception score while breathing through an inspiratory muscle trainer at each admission. Poor perceiver was defined as a Borg score of ≤5 at the highest resistive load (HR) and HR-induced ΔBorg score of ≤3. Result: Between the first and second admissions, the relationship of forced expiratory volume in 1 s (r=0.773, P ＜0.001) and the concordance of severity of asthma attack (κ=0.503, P＜0.001) were significant, but the relationship of HR-induced ΔBorg score and the concordance of poor perceivers were not. During the first admission, as lung function increased gradually, the HR-induced ΔBorg score became higher in poor perceivers (1.83±0.39→3.42±0.57→4.00±0.67, P=0.048). Conclusion: Although asthmatic patients who suffered from a severe asthma attack tended to have a severe attack again at the following admission, dyspnea perception differs among the admissions. Impaired dyspnea perception during acute asthmatic attack would be correctable with anti-asthma treatments.
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