Korean J Intern Med.
2008 Dec;23(4):170-175. 10.3904/kjim.2008.23.4.170.
Factors for poor prognosis of near-fatal asthma after recovery from a life-threatening asthma attack
- Affiliations
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- 1Department of Internal Medicine, College of Medicine Ewha Womans University, Ewha Medical Research Institute, Seoul, Korea. mengkkong@hanmail.net
- 2Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, Seoul National University College of Medicine, Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.
- KMID: 1100764
- DOI: http://doi.org/10.3904/kjim.2008.23.4.170
Abstract
- BACKGROUND/AIMS: The aim of this study was to investigate poor prognostic factors associated with a near-fatal asthma attack following patient recovery. METHODS: We enrolled 68 patients who suffered near-fatal asthma attacks and were admitted to the intensive care units of five university hospitals. The patients were divided into two groups. The first group was comprised of patients who discontinued oral corticosteroids within 6 months after being discharged from the hospital and who maintained a forced expiratory volume in 1 s (FEV1) > or =60% of the maximum or estimated values of the corresponding patients. The second group included patients who continued on oral corticosteroids for > or =6 months or who maintained a FEV1 <60%. RESULTS: In patients with near-fatal asthma, factors for a poor prognosis included older age [48.47+/-3.53 vs. 64.69+/-2.59 years, p<0.05], chronic severe asthma, high values for inflammation-related laboratory markers (ESR, 8.75+/-2.05 vs. 23.88+/-4.40 mm/h, p=0.004; CRP, 1.72+/-0.46 vs. 6.68+/-9.36 mg/dL, p<0.05), asthma exacerbated by pneumonia (28.1 vs. 52.8%, p<0.05), and relatively low nutritional status (albumin, 4.00+/-0.14 vs. 3.51+/-0.10 g/dL, p<0.05). CONCLUSIONS: These prognostic factors may induce irreversible obstruction of the airways with subsequent acute exacerbation of asthma or the need for continual oral corticosteroids after being discharged from the hospital. Patients with these factors should be treated appropriately, under close surveillance.
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