Risk factors for near-fatal asthma : a case-control study in a western cape teaching hospital

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dc.contributor.authorDe Klerk, A.en_ZA
dc.contributor.authorVan Schalkwyk, E.en_ZA
dc.contributor.authorWilliams, Z.en_ZA
dc.contributor.authorLee, W.en_ZA
dc.contributor.authorBardin, P.en_ZA
dc.date.accessioned2011-03-18T14:59:27Z
dc.date.available2011-03-18T14:59:27Z
dc.date.issued2002
dc.descriptionCITATION: De Klerk, A. et al. 2002. Risk factors for near-fatal asthma : a case-control study in a western cape teaching hospital. South African Medical Journal, 92:140-144.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground and objectives. To evaluate risk factors for asthma death such as access to health care, over-use of β2-agonists or under-use of inhaled corticosteroids in the Western Cape (WC) population, using near-fatal asthma (NFA) as a surrogate marker. Subjects and methods. Patients with NFA (cases) admitted to a WC teaching hospital were compared with patients with acute asthma in a case-control study using a structured questionnaire, clinical examination, arterial blood gas measurements, chest radiograph and pulmonary function measurements. Results. Sixteen patients with NFA (cases) and 55 with acute asthma (controls) were prospectively enrolled. Duration of asthma, gender, smoking status and ethnicity were similar. Cases had significantly more previous mechanical ventilation (P < 0.05) and a trend towards more previous intensive care unit (ICU) admissions. No significant differences were found in primary health care variables. Conclusion. Our study demonstrates that patients with NFA constitute a significant number of emergency room (ER) admissions for acute asthma (30%) in our population. Similar to other studies, there was a trend for NFA toward more previous ICU admissions and mechanical ventilation. Relative under-use of β2-agonists the day before admission and fewer ER visits during the previous year in the NFA group, suggests an impaired perception of the severity of disease or a more rapid onset of symptoms. Negative factors such as inability to access health care or lack of medication supply were similar in both groups. The challenge remains to identify and manage high-risk patients effectively.
dc.description.versionPublisher’s version
dc.format.extent5 pages
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.urihttp://hdl.handle.net/10019.1/7840
dc.language.isoen
dc.publisherHealth & Medical Publishing Group
dc.rights.holderSouth African Medical Journal
dc.subjectAsthmaen_ZA
dc.titleRisk factors for near-fatal asthma : a case-control study in a western cape teaching hospitalen_ZA
dc.typeArticle
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