A RISK SCREENING QUESTIONNAIRE FOR ADULT ASTHMATICS TO PREDICT ATTENDANCE AT HOSPITAL EMERGENCY DEPARTMENTS

Study objectives: To develop a practical screening tool that could ide ntify adult patients highly likely to attend a hospital emergency depa rtment (ED) in a 1-year period. Design: Retrospective case-control stu dy of patients who did and did not attend a hospital ED for asthma in the past year. Setting: Adelaide, South Australia. Participants: One h undred sixty-five adults attending an ED for asthma were compared with 260 adults with asthma from a community survey who had not attended a n ED in the previous par. Measurements and results: The following vari ables were independently related to ED attendance: having been woken f rom sleep by asthma in past month; having been admitted to hospital be cause of asthma in the past year; having seen more than one general pr actitioner for asthma in the last 12 months; a moderate or severe self -rating of asthma in the last month; and having taken oral steroid med ication for asthma in past month. A risk screening questionnaire using the weighted responses to these five variables with a cutoff score of 30/100 demonstrated a sensitivity of 90% and specificity of 88%. Conc lusions: These findings agree with those of previous studies that mark ers of asthma severity and discontinuity of care are risk factors for adverse asthma outcomes. Validation of the risk screening questionnair e is required in a prospective study.