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Abstract：
OBJECTIVE: To analyze the characteristics of adult patients admitted for asthma exacerbation and determine optimization, treatment adherence, and follow-up in clinics.
METHODS: Patients ≥ 18 years old admitted from May 2021 to June 2023 with a primary diagnosis of asthma exacerbation were included. Patients with a secondary diagnosis of asthma exacerbation and those without a confirmed diagnosis were excluded.
RESULTS: A total of 186 patients were analyzed, 63% were female, with a mean age of 49 ± 34 years, mean body mass index (BMI) of 26.4 ± 5 kg/m2, mean immunoglobulin E level of 132 ± 235 IU/mL (range: 25-2041), mean eosinophils count of 180 ± 443, and length of stay of 8.6 ± 5 days. Comparing patients with one admission to those with multiple admissions, differences were observed in age (39 ± 15 vs. 58 ± 20, p < 0.0001), BMI (25.2 ± 3 vs. 27.4 ± 4, p < 0.0003), comorbidity (15% vs. 60%, p < 0.0001), and length of stay (4.5 ± 2 vs. 11 ± 3, p < 0.0001). Of the patients, 15% had undiagnosed asthma, 28% had known asthma without maintenance therapy, 23% were managed by primary care, and 34% were followed by pneumology. The mean Test of Adherence to Inhalers (TAI) score was 42.5 ± 8 points, with 70% showing erratic non-adherence, 46% showing deliberate non-adherence, and 21% showing unconscious non-adherence.
CONCLUSIONS: The young population represents a significant percentage of admissions for asthma exacerbation due to poor follow-up in pulmonology clinics, inadequate treatment optimization, and low adherence. This study adds that it is necessary to improve the approach to asthma in primary care to optimize treatment, reduce under-diagnosis, and avoid hospital admissions.
METHODS: Patients ≥ 18 years old admitted from May 2021 to June 2023 with a primary diagnosis of asthma exacerbation were included. Patients with a secondary diagnosis of asthma exacerbation and those without a confirmed diagnosis were excluded.
RESULTS: A total of 186 patients were analyzed, 63% were female, with a mean age of 49 ± 34 years, mean body mass index (BMI) of 26.4 ± 5 kg/m2, mean immunoglobulin E level of 132 ± 235 IU/mL (range: 25-2041), mean eosinophils count of 180 ± 443, and length of stay of 8.6 ± 5 days. Comparing patients with one admission to those with multiple admissions, differences were observed in age (39 ± 15 vs. 58 ± 20, p < 0.0001), BMI (25.2 ± 3 vs. 27.4 ± 4, p < 0.0003), comorbidity (15% vs. 60%, p < 0.0001), and length of stay (4.5 ± 2 vs. 11 ± 3, p < 0.0001). Of the patients, 15% had undiagnosed asthma, 28% had known asthma without maintenance therapy, 23% were managed by primary care, and 34% were followed by pneumology. The mean Test of Adherence to Inhalers (TAI) score was 42.5 ± 8 points, with 70% showing erratic non-adherence, 46% showing deliberate non-adherence, and 21% showing unconscious non-adherence.
CONCLUSIONS: The young population represents a significant percentage of admissions for asthma exacerbation due to poor follow-up in pulmonology clinics, inadequate treatment optimization, and low adherence. This study adds that it is necessary to improve the approach to asthma in primary care to optimize treatment, reduce under-diagnosis, and avoid hospital admissions.
摘要：
目的：分析成人哮喘急性发作患者的特点，治疗依从性，和诊所的后续行动。
方法：纳入2021年5月至2023年6月主要诊断为哮喘加重的≥18岁患者。二次诊断为哮喘加重的患者和未确诊的患者被排除在外。
结果：共分析了186例患者，63%是女性，平均年龄为49±34岁，平均体重指数（BMI）为26.4±5kg/m2，平均免疫球蛋白E水平为132±235IU/mL（范围：25-2041），平均嗜酸性粒细胞计数为180±443，住院时间为8.6±5天。将一次入院的患者与多次入院的患者进行比较，观察到年龄差异(39±15vs.58±20，p<0.0001），BMI（25.2±3vs.27.4±4，p<0.0003），合并症(15%与60%,p<0.0001),和停留时间(4.5±2vs.11±3，p<0.0001)。在患者中，15%的人患有未确诊的哮喘,28%的人已知哮喘没有维持治疗，23%由初级保健管理，34％其次是肺炎。坚持吸入器的平均测试（TAI）评分为42.5±8分，70%的人表现出反复无常的不坚持，46%的人表现出故意不坚持，21%的人表现出无意识的不依从。
结论：由于肺科诊所的随访不佳，年轻人群占哮喘急性发作患者的很大比例。治疗优化不足，低坚持。这项研究补充说，有必要改善初级保健中的哮喘治疗方法，以优化治疗，减少诊断不足，避免入院。
方法：纳入2021年5月至2023年6月主要诊断为哮喘加重的≥18岁患者。二次诊断为哮喘加重的患者和未确诊的患者被排除在外。
结果：共分析了186例患者，63%是女性，平均年龄为49±34岁，平均体重指数（BMI）为26.4±5kg/m2，平均免疫球蛋白E水平为132±235IU/mL（范围：25-2041），平均嗜酸性粒细胞计数为180±443，住院时间为8.6±5天。将一次入院的患者与多次入院的患者进行比较，观察到年龄差异(39±15vs.58±20，p<0.0001），BMI（25.2±3vs.27.4±4，p<0.0003），合并症(15%与60%,p<0.0001),和停留时间(4.5±2vs.11±3，p<0.0001)。在患者中，15%的人患有未确诊的哮喘,28%的人已知哮喘没有维持治疗，23%由初级保健管理，34％其次是肺炎。坚持吸入器的平均测试（TAI）评分为42.5±8分，70%的人表现出反复无常的不坚持，46%的人表现出故意不坚持，21%的人表现出无意识的不依从。
结论：由于肺科诊所的随访不佳，年轻人群占哮喘急性发作患者的很大比例。治疗优化不足，低坚持。这项研究补充说，有必要改善初级保健中的哮喘治疗方法，以优化治疗，减少诊断不足，避免入院。
