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ASTHMATICS WITH MODERATE OR SEVERE SYMPTOMS LASTING MORE THAN SIX HOURS LIKELY TO REQUIRE HOSPITAL ADMISSION
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People with moderate or severe asthma
whose symptoms have lasted for more than six hours are more likely to require hospital admission for further treatment than people with a shorter duration of symptoms.
This raises the possibility that different types of acute asthma may require different treatment.
This is the finding of a study of 350 patients presenting to 20 Australian emergency departments.
The study was conducted to determine whether, for patients with moderate or severe asthma presenting to emergency departments, there is a difference in need for hospitalisation between those with a duration of symptoms less than six hours and those with a longer duration of symptoms.
Conducted by Professor Anne-Maree Kelly, from the Joseph Epstein Centre for Emergency Medicine Research at Western Hospital in Melbourne, paediatrician Colin Powell, and researcher Debra Kerr, the study is reported in the latest issue of Emergency Medicine, the journal of the Australasian College for Emergency Medicine.
"It is increasingly being suggested that patients with acute attacks of asthma of shorter duration represent a distinct phenotype of the asthma syndrome that may respond differently to therapy," Professor Kelly said.
"Our data support this, showing that patients with a longer duration of symptoms were more likely to require hospital admission."
The reasons are not clear, she said.
"It may be due to a difference in the balance between bronchospasm due to inhaled triggers and inflammation, the major hallmarks of this disease."
Shorter onset asthma may have a predominantly allergic basis, she said.
This means it is possible that the two groups will respond differently to emergency management.
"Those with predominant bronchospasm may respond more rapidly to aggressive beta-agonist therapy while those with a predominant inflammatory component may take longer to respond."
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