Early prediction of poor outcome in patients with acute asthma in the emergency room
Autor(a) principal: | |
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Data de Publicação: | 2002 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/21118 |
Resumo: | Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50% of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9%) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1%) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 h £0% of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2. |
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Mallmann, FelipeFernandes, E. M.Ávila, Eduardo MullerNogueira, Fernando LopesSteinhorst, Ana Maria PasqualiSaucedo, Dumitriu ZuninoMachado, Francisco JuchemRaymundi, Marcelo GregorioDalcin, Paulo de Tarso RothMenna Barreto, Sérgio Saldanha2010-04-24T04:15:23Z20020100-879Xhttp://hdl.handle.net/10183/21118000353693Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50% of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9%) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1%) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 h £0% of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2.application/pdfengBrazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 35, no. 1 (Jan. 2002), p. 39-47Estado asmáticoAsmaEmergênciasCuidados críticosPrognósticoAsthmaOutcomeIndexPrognosisEmergency medicineEarly prediction of poor outcome in patients with acute asthma in the emergency roominfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSORIGINAL000353693.pdf000353693.pdfTexto completo (inglês)application/pdf109748http://www.lume.ufrgs.br/bitstream/10183/21118/1/000353693.pdf323398045ce26db3bef469b3acd86bf9MD51TEXT000353693.pdf.txt000353693.pdf.txtExtracted Texttext/plain32117http://www.lume.ufrgs.br/bitstream/10183/21118/2/000353693.pdf.txtc110d122de49759033f69792780678c1MD52THUMBNAIL000353693.pdf.jpg000353693.pdf.jpgGenerated Thumbnailimage/jpeg1559http://www.lume.ufrgs.br/bitstream/10183/21118/3/000353693.pdf.jpg8632c72f2f98afdb4e454b83b1c3d4ebMD5310183/211182023-11-16 04:23:26.738585oai:www.lume.ufrgs.br:10183/21118Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-11-16T06:23:26Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Early prediction of poor outcome in patients with acute asthma in the emergency room |
title |
Early prediction of poor outcome in patients with acute asthma in the emergency room |
spellingShingle |
Early prediction of poor outcome in patients with acute asthma in the emergency room Mallmann, Felipe Estado asmático Asma Emergências Cuidados críticos Prognóstico Asthma Outcome Index Prognosis Emergency medicine |
title_short |
Early prediction of poor outcome in patients with acute asthma in the emergency room |
title_full |
Early prediction of poor outcome in patients with acute asthma in the emergency room |
title_fullStr |
Early prediction of poor outcome in patients with acute asthma in the emergency room |
title_full_unstemmed |
Early prediction of poor outcome in patients with acute asthma in the emergency room |
title_sort |
Early prediction of poor outcome in patients with acute asthma in the emergency room |
author |
Mallmann, Felipe |
author_facet |
Mallmann, Felipe Fernandes, E. M. Ávila, Eduardo Muller Nogueira, Fernando Lopes Steinhorst, Ana Maria Pasquali Saucedo, Dumitriu Zunino Machado, Francisco Juchem Raymundi, Marcelo Gregorio Dalcin, Paulo de Tarso Roth Menna Barreto, Sérgio Saldanha |
author_role |
author |
author2 |
Fernandes, E. M. Ávila, Eduardo Muller Nogueira, Fernando Lopes Steinhorst, Ana Maria Pasquali Saucedo, Dumitriu Zunino Machado, Francisco Juchem Raymundi, Marcelo Gregorio Dalcin, Paulo de Tarso Roth Menna Barreto, Sérgio Saldanha |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Mallmann, Felipe Fernandes, E. M. Ávila, Eduardo Muller Nogueira, Fernando Lopes Steinhorst, Ana Maria Pasquali Saucedo, Dumitriu Zunino Machado, Francisco Juchem Raymundi, Marcelo Gregorio Dalcin, Paulo de Tarso Roth Menna Barreto, Sérgio Saldanha |
dc.subject.por.fl_str_mv |
Estado asmático Asma Emergências Cuidados críticos Prognóstico |
topic |
Estado asmático Asma Emergências Cuidados críticos Prognóstico Asthma Outcome Index Prognosis Emergency medicine |
dc.subject.eng.fl_str_mv |
Asthma Outcome Index Prognosis Emergency medicine |
description |
Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50% of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9%) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1%) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 h £0% of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2. |
publishDate |
2002 |
dc.date.issued.fl_str_mv |
2002 |
dc.date.accessioned.fl_str_mv |
2010-04-24T04:15:23Z |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10183/21118 |
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0100-879X |
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000353693 |
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http://hdl.handle.net/10183/21118 |
dc.language.iso.fl_str_mv |
eng |
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eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Brazilian journal of medical and biological research. Ribeirão Preto, SP. Vol. 35, no. 1 (Jan. 2002), p. 39-47 |
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