Comparison of The Emergency Department Length of Stay Before and After Using the Vajira Hospital Asthmatic Care Guidelines

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Prakit Janngarm
Chunlanee Sungketchon

Abstract

Objective: This study aimed to compare lengths of emergency department length of stay, admission rates and revisit rates in acute asthmatic patients who had moderate and severe clinical pictures before and after using Vajira hospital asthmatic care guidelines.


Methods: This was a retrospective comparative study. Medical records of patients who were older than 18-year-old and had moderate and severe asthmatic attack were reviewed. A total of 253 asthmatic patients were collected, including those who did not receive Vajira hospital asthmatic care guidelines according to the 127 asthmatic and receive Vajira hospital asthmatic care guidelines groups for the 126 asthma patients.


Results: Based on data analysis, it was found that recurrent asthmatic patients who did not receive and received Vajira hospital asthmatic care guidelines. The median emergency department length of stay was 210 minutes (IQR = 120-390 minutes) and 207 minutes (IQR = 119 - 364 minutes) respectively, admission rates 4.70% and 6.30% respectively, and revisit rates in acute asthmatic patients was 6.70% and 4.80%, respectively. When comparing the differences in the pre and post receive Vajira hospital asthmatic care guidelines, there was no statistically significant difference at the 0.05 level.


Conclusion: Patients with asthmatic patients who were treated according to Vajira hospital asthmatic care guidelines. showed no statistically significant difference in the duration of treatment in asthmatic patients at Vajira Hospital, Emergency medicine department inpatient admission rate and the recurrence rate at the emergency medicine department.

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References

Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee. Lancet 1998;351(9111):1225-32.

Weber EJ, Silverman RA, Callaham ML, Pollack CV, Woodruff PG, Clark S, et al. A prospective multicenter study of factors associated with hospital admission among adults with acute asthma. Am J Med 2002;113(5):371–8.

Sears MR. Epidemiology of asthma exacerbations. J Allergy Clin Immunol 2008; 122(4): 662–8.

Guidelines for the treatment of asthma for adults. The Medical Council of Thailand 1995;24(1):17-29.

Kanit Sap A, Wang W. Guidelines for diagnosis and treatment of asthma in Thailand V.5 for adults and children 2012. Bangkok: Union Ultra Violet; 2012.

Global Initiative for Asthma. The Global Initiative for Asthma (GINA) [Internet]. 2021 [cited 2021 Jan 21] Available from: http://www.ginasthma.org/About-Us.

Fang X, Li S, Gao L, Zhao N, Wang X, Bai C. A short-term educational program improved physicians’ adherence to guidelines for COPD and asthma in Shanghai. Clin Transl Med 2012;1: 13. doi: 10.1186/2001-1326-1-13.

Bhulani N, Lalani S, Ahmed A, Jan Y, Faheem U, Khan A, et al. Knowledge of asthma management by general practitioners in Karachi, Pakistan: comparison with international guidelines. Prim Care Respir J 2011; 20(4): 448–51.

Chua F, Lai D. Acute severe asthma: Triage, treatment and thereafter. Curr Anaesth Crit Care 2007; 18(2): 61–8.

Global Initiative for Asthma. Pocket Guide for Asthma Management and Prevention [Internet]. 2021 [cited 2021 Jan 21] Available from: http://www.ginasthma.org/documents/1.

Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH. Early use of inhaled corticosteroids in the emergency department treatment of acute asthma. Cochrane Database Syst Rev 2012; 12(12): CD002308. doi: 10.1002/14651858.CD002308.

Lee TA, Chang CL, Stephenson JJ, Sajjan SG, Maiese EM, Everett S, et al. Impact of asthma controller medications on medical and economic resource utilization in adult asthma patients. Curr Med Res Opin 2010; 26(12):2851–60.

Boskabady MH, Rezaeitalab F, Rahimi N, Dehnavi D. Improvement in symptoms and pulmonary function of asthmatic patients due to their treatment according to the Global Strategy for Asthma Management (GINA). BMC Pulm Med 2008; 8:26. doi: 10.1186/1471-2466-8-26.

Rodríguez-Trigo G, Plaza V, Picado C, Sanchis J. Management according to the Global Initiative for Asthma guidelines of patients with near-fatal asthma reduces morbidity and mortality. Arch Bronconeumol 2008; 44(4):192–6.

Goodacre S, Bradburn M, Cohen J, Gray A, Benger J, Coats T, et al. Prediction of unsuccessful treatment in patients with severe acute asthma. Emerg Med J 2014; 31(e1):e40-5.

Edmonds ML, Milan SJ, Camargo CA Jr, Pollack CV, Rowe BH. Early use of inhaled corticosteroids in the emergency department treatment of acute asthma. Cochrane Database Syst Rev 2012; 12 (12):CD002308. doi: 10.1002/14651858.CD002308.pub2.

Ruengsak Srisupa. The study recurrent asthmatic attack patients in Khamcha-I hospital. Journal of the office of ODPC 7 Khon Kaen 2012; 11:10-20.