Crompton G K, Grant I W, Bloomfield P
Br Med J. 1979 Nov 10;2(6199):1199-201. doi: 10.1136/bmj.2.6199.1199.
In December 1968 an emergency service was begun in Edinburgh to expedite admission to hospital of patients with severe acute asthma. During the first 10 years requests were made to admit 112 patients to a respiratory unit with provision for intensive care on 360 occasions. Four of the patients died of their disease, one in hospital and three before admission. It was thought that the death rate would have been much higher had conventional admission procedures been observed. Owing to ethical objections to a controlled trial it was not possible to obtain substantive proof that the service reduced deaths from asthma. Nevertheless, there was strong circumstantial evidence that organised facilities for the immediate admission to hospital of patients with a history of life-threatening attacks would result in fewer deaths at home. Earlier admission also apparently reduced hospital mortality and the number of patients requiring tracheal intubation and mechanical ventilation. It is concluded that there is a prima facie case for an emergency asthma admission serivce similar to that operating in Edinburgh to be established in all cities and large towns.
1968年12月，爱丁堡启动了一项急救服务，以加快重症急性哮喘患者的住院速度。在最初的10年里，有112名患者被要求入住呼吸科病房，并在360个场合接受重症监护。其中4名患者死于该病，1名在住院期间死亡，3名在入院前死亡。人们认为，如果遵循传统的入院程序，死亡率会高得多。由于伦理方面对对照试验的反对，无法获得该服务降低哮喘死亡率的实质性证据。然而，有强有力的间接证据表明，为有危及生命发作史的患者立即入院提供有组织的设施，将减少在家中的死亡人数。早期入院显然也降低了医院死亡率以及需要气管插管和机械通气的患者数量。结论是，有初步证据表明，应在所有城市和大城镇建立类似爱丁堡运作的紧急哮喘入院服务。
