Kuan Win Sen, Craig Simon, Kelly Anne-Maree, Keijzers Gerben, Klim Sharon, Graham Colin A, Jones Peter, Holdgate Anna, Lawoko Charles, Laribi Said
Emergency Medicine Department, National University Hospital, National University Health System, Singapore, Singapore.
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Clin Respir J. 2018 Jun;12(6):2117-2125. doi: 10.1111/crj.12782. Epub 2018 Mar 24.
Shortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes.
The aim of this study was to describe the demographic features, clinical characteristics, management and outcomes of adults with an ED diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea.
Planned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study. AANZDEM was a prospective cohort study conducted in 46 EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia over three 72 hour periods in May, August and October 2014. Primary outcomes were patient epidemiology, clinical features, treatment and outcomes (hospital length of stay (LOS) and mortality).
Of the 3044 patients with dyspnea, 387 (12.7%) patients had an ED diagnosis of asthma. The median age was 45 years, 60.1% were female, 16.1% were active or recent smokers and 30.4% arrived by ambulance. Inhaled bronchodilator therapy was initiated in 88.1% of patients, and 66.9% received both inhaled bronchodilators and systemic corticosteroids. After treatment in the ED, 65.4% were discharged. No death was reported.
Asthma is common among patients presenting with a principal symptom of dyspnea in the ED of the Asia Pacific region. There was a suboptimal adherence to international guidelines on investigations and treatments of acute asthma exacerbations presenting an opportunity to improve the efficiency of care.
呼吸急促是急诊科常见的就诊症状，可能由多种诊断引起。哮喘是主要病因之一。
本研究旨在描述在亚太地区急诊科以呼吸困难为主要症状、被诊断为哮喘的成人患者的人口统计学特征、临床特点、治疗及结局。
对在亚洲、澳大利亚和新西兰急诊科呼吸困难研究（AANZDEM）中被急诊科诊断为哮喘的患者进行计划中的子研究。AANZDEM是一项前瞻性队列研究，于2014年5月、8月和10月的三个72小时期间在澳大利亚、新西兰、新加坡及香港和马来西亚的46家急诊科进行。主要结局包括患者流行病学、临床特征、治疗及结局（住院时间（LOS）和死亡率）。
在3044例呼吸困难患者中，387例（12.7%）被急诊科诊断为哮喘。中位年龄为45岁，60.1%为女性，16.1%为现吸烟者或近期吸烟者，30.4%由救护车送来。88.1%的患者开始接受吸入支气管扩张剂治疗，66.9%的患者同时接受了吸入支气管扩张剂和全身用糖皮质激素治疗。在急诊科治疗后，65.4%的患者出院。无死亡报告。
在亚太地区急诊科以呼吸困难为主要症状的患者中，哮喘很常见。在急性哮喘加重的检查和治疗方面，对国际指南的依从性欠佳，这为提高医疗效率提供了契机。
