Abstract
Introduction: Systemic corticosteroids are commonly used in management of acute asthma, sometimes started before admission in emergency department, sometimes in ward after admission. This study is to determine whether commencing systemic corticosteroids in emergency department compared to in ward for managing acute adult asthma requiring hospitalization can improve the outcome: shorter length of hospital stay.Methods: A retrospective cohort study was conducted in an emergency department in Hong Kong. Adults aged 18 to 65 years-old who presented to the emergency department with acute asthma and subsequently hospitalized with use of systemic corticosteroids were recruited and divided into two groups: a group with commencement of systemic corticosteroids in emergency department (Group A, n=139) and the other group with commencement of systemic corticosteroids in ward (Group B, n=209). The outcome measurement was length of hospital stay.Results: A total of 348 subjects were recruited in final analyses. We used Mann-Whitney U test to test the difference in ranking of length of hospital stay (days) between these two groups. The mean rank of length of hospital stay in Group A was 159, and that in Group B was 185 (p=0.014). The difference was statistically significant with commencement of systemic corticosteroids in emergency department resulting in higher ranking-shorter length of hospital stay.Conclusion: It may be possible to result in earlier discharge in acute adult asthma requiring hospitalization when systemic corticosteroids is started before admission in emergency department, instead of in ward after admission.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.608-614
Highlights
Systemic corticosteroids are commonly used in management of acute asthma, sometimes started before admission in emergency department, sometimes in ward after admission
A Cochrane review showed that use of systemic corticosteroids within 1 hour of presentation to an emergency department can significantly reduce the need for hospital admission in patients with acute asthma[17]
It was a retrospective cohort study to test the difference in ranking of length of hospital stay between 2 groups of acute adult asthma: a group with commencement of systemic corticosteroids in emergency department before admission (Group A, n=139) and the other group with commencement of systemic corticosteroids in ward (Group B, n=209)
Summary
Systemic corticosteroids are commonly used in management of acute asthma, sometimes started before admission in emergency department, sometimes in ward after admission. This study is to determine whether commencing systemic corticosteroids in emergency department compared to in ward for managing acute adult asthma requiring hospitalization can improve the outcome: shorter length of hospital stay. The difference was statistically significant with commencement of systemic corticosteroids in emergency department resulting in higher ranking-shorter length of hospital stay. Conclusion: It may be possible to result in earlier discharge in acute adult asthma requiring hospitalization when systemic corticosteroids is started before admission in emergency department, instead of in ward after admission. A Cochrane review showed that use of systemic corticosteroids within 1 hour of presentation to an emergency department can significantly reduce the need for hospital admission in patients with acute asthma[17]. Systemic corticosteroids can help to reduce the rate of relapse; and it should be administered to patients with severe asthma[18,19,20,21]
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