Watson L, Turk F, Rabe K F
Louise Watson Consulting Ltd, Buxton, UK.
Int J Clin Pract. 2007 Nov;61(11):1884-8. doi: 10.1111/j.1742-1241.2007.01559.x. Epub 2007 Sep 14.
This study was designed to report factors associated with asthma hospital admission, such as patient characteristics, type of admission and subsequent outcome i.e. discharge or death, for the years 2000-2005. These data are used for health economic models regarding asthma burden in the hospital setting in Australia.
Data was obtained from the Australian Centre for Asthma Monitoring using their amalgamated dataset from all states and territories. Admissions under ICD-10 codes J45 'Asthma' plus all subcodes, and J46 'acute severe asthma' were included. Codes for associated comorbidity at the time of admission were identified, as well as the month of death, age, gender and length and the type of stay. Confidence intervals for death rate assumed a binomial distribution because of the rarity of event.
The total number of all-cause deaths for the 5-year observation period was 289 from 202,739 asthma separations or 0.14% or 143 deaths/100,000 separations and the highest rate was seen in patients over 45 years. Acute upper respiratory tract infections were reported in up to 25% of all asthma hospital admissions. Length of stay was up to a mean average of 10.2 days in patients who died (SD 15.3). In 5 years observation there was 152,758 emergency asthma admissions which contributed greatly to Australian healthcare burden.
The study demonstrates that emergency admissions dominate asthma care in the hospital setting in Australia, which suggests poor asthma control in some patients with subsequent economic burden. Asthma-related mortality remains a risk for specific patients in the hospital setting.
本研究旨在报告2000 - 2005年期间与哮喘住院相关的因素，如患者特征、住院类型及后续结局（即出院或死亡）。这些数据用于澳大利亚医院环境中哮喘负担的健康经济模型。
数据来自澳大利亚哮喘监测中心，使用的是来自所有州和领地的合并数据集。纳入国际疾病分类第十版（ICD - 10）编码J45“哮喘”及其所有子编码，以及J46“急性重症哮喘”下的住院病例。确定了入院时相关合并症的编码，以及死亡月份、年龄、性别、住院时长和住院类型。由于事件罕见，死亡率的置信区间假定为二项分布。
在5年观察期内，202,739例哮喘出院病例中有289例全因死亡，死亡率为0.14%或143例/100,000例出院病例，45岁以上患者的死亡率最高。高达25%的哮喘住院病例报告有急性上呼吸道感染。死亡患者的平均住院时长为10.2天（标准差15.3）。在5年观察期内，有152,758例哮喘急诊入院，这给澳大利亚的医疗负担带来了巨大影响。
该研究表明，急诊入院在澳大利亚医院环境中的哮喘治疗中占主导地位，这表明一些患者的哮喘控制不佳，随后带来了经济负担。在医院环境中，特定患者仍面临哮喘相关死亡风险。
