Abstract
Asthma is an ever-increasing disease with a highly variable prevalence among different ethnic groups. Information on hospital admission for acute exacerbation of asthma in adult patients and data regarding short-term prognosis of these patients are limited. We, thus, performed an epidemiological study on hospital admission for asthma acute exacerbation in Italy using hospital discharge database records derived from all Italian hospitals. Patients > 15 years old were identified using clinical Modification (ICD-9-CM) codes. Information on baseline characteristics, vital status at discharge, duration of hospitalization, and up to five secondary discharge diagnoses was collected. Comorbidity was evaluated using the Charlson comorbidity index (CCI). During the observation period (2013–2014), 20,056 patients with asthma acute exacerbation were hospitalized. Median length of hospitalization was 7.9 days (interquartile range 4–10) and mean in-hospital mortality was 0.8%. In-hospital mortality and length of hospitalization varied among different regions (from 0 to 2.9% and from 6.5 to 8.9 days, respectively). Old age, invasive and non-invasive mechanical ventilation, and CCI resulted as significantly associated with higher in-hospital mortality. Our study results, on a large sample of patients, confirm that hospitalization for asthma acute exacerbation is not uncommon among Italian current population. Older age, high CCI, and use of ventilator support were associated with a higher mortality rate. These findings should be analyzed to set up appropriate health care policies on patients with asthma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Enilari O, Sinha S (2019) The global impact of asthma in adult populations. Ann Glob Health 85(1):1–7
Kaur BP, Lahewala S, Arora S, Agnihotri K, Panaich SS, Secord E, Levine D (2015) Hospitalization trends and predictors of in-hospital mortality and hospitalization costs in the USA (2001–2010). Int Arch Allergy Immunol 168:71–78
Santos N, Bugalho de Almeida A, Covas A, Prates L, Morais-Almeida M (2016) Trends of asthma hospitalization and hospital mortality in mainland Portugal. Eur Ann Allergy Clin Immunol 48(N6):237–241
Braman SS (2017) Asthma in the elderly. Clin Geriatr Med 33(4):523–537
Montagnani A, Mathieu G, Pomero F, Bertù L, Manfellotto D, Campanini M, Fontanella A, Sposato B, Dentali F (2020) Hospitalization and mortality for acute exacerbation of chronic obstructive pulmonary disease (COPD): an Italian population-based study. Eur Rev Med Pharmacol Sci 24(12):6899–6907
Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383
Carrillo G, Mendez-Domínguez N, Datta-Banik R, Figueroa-Lopez F, Estrella-Chan B, Alvarez-Baeza A, Garza N (2020) Asthma mortality and hospitalizations in Mexico from 2010 to 2018: retrospective epidemiologic profile. Int J Environ Res Public Health 17(14):5071
Stefan MS, Nathanson BH, Lagu T, Priya A, Pekow PS, Steingrub JS, Hill NS, Goldberg RJ, Kent DM, Lindenauer PK (2016) Outcomes of noninvasive and invasive ventilation in patients hospitalized with asthma exacerbation. Ann Am Thorac Soc 13(7):1096–1104
Green E, Jain P, Bernoth M (2017) Noninvasive ventilation for acute exacerbations of asthma: a systematic review of the literature. Aust Crit Care 30(6):289–297. https://doi.org/10.1016/j.aucc.2017.01.003 (Epub 2017 Jan 27 PMID: 28139368)
Bauer RN, Yang X, Staton TL, Olsson J, Holweg CTJ, Arron JR, Matthews JG, Choy DF (2019) Seasonal variability of lung function and asthma quality of life questionnaire scores in adults with uncontrolled asthma. BMJ Open Respir Res 6(1):e000406. https://doi.org/10.1136/bmjresp-2019-000406 (PMID: 31803473; PMCID: PMC6890391)
Alvarez GG, Schiulzer M, Jung D, Fitzgerald JM (2005) A Systematic review of risk factors associated with near-fatal and fatal asthma. Can Respir J 12(5):265–270
Soto-Campos JG, Plaza V, Soriano JB et al (2013) Causes of death in asthma, COPD and non-respiratory hospitalized patients: a multicentric study. BMC Pulm Med 13:73
Gautier C, Charpin D (2017) Environmental triggers and avoidance in the management of asthma. J Asthma Allergy 7(10):47–56. https://doi.org/10.2147/JAA.S121276 (PMID:28331347;PMCID:PMC5349698)
Soyiri IN, Reidpath DD, Sarran C (2011) Asthma length of stay in hospitals in London 2001–2006: demographic, diagnostic and temporal factors. PLoS ONE 6(11):e27184. https://doi.org/10.1371/journal.pone.0027184
Boulet LP, Boulay MÈ (2011) Asthma-related comorbidities. Expert Rev Respir Med 5(3):377–393. https://doi.org/10.1586/ers.11.34 (PMID:21702660)
Funding
No funds were used.
Author information
Authors and Affiliations
Consortia
Corresponding author
Ethics declarations
Conflict of interest
All authors declare no conflicts of interest.
Human and animal rights statement and Informed consent
All authors equally participated. Institutional Review Board of each participating centre approved the study waiving the need for written informed consent due to the nature of the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Para, O., Montagnani, A., Guidi, S. et al. Hospitalization and mortality for acute exacerbation of asthma: an Italian population-based study. Intern Emerg Med 17, 1107–1113 (2022). https://doi.org/10.1007/s11739-021-02923-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11739-021-02923-5