PREDICTION OF RELAPSE WITHIN 8 WEEKS AFTER AN ACUTE ASTHMA EXACERBATION IN ADULTS

Associations between historical, presenting, and treatment-related cha racteristics and relapse within 8 weeks after a moderate to severe ast hma exacerbation were studied in a cohort of 284 adult asthmatics. Dat a were collected prospectively, and a multivariate model was developed and internally validated. Within 10 days, only 8% had relapsed, incre asing to 45% by 8 weeks. Three variables that could be identified at t he time of discharge were independently associated with relapse. These included: having made three or more visits to an emergency department in the prior 6 months (hazard ratio (HR) = 2.3, 95% CI = 1.6-3.4); di fficulty performing work or activities as a result of physical health in the 4 weeks prior (HR = 2.7, 95% CI = 1.6-4.3); discontinuing hospi tal-based treatment for the exacerbation within 24 hours without havin g achieved a peak expiratory flow rate of at least 50% of predicted (H R = 2.6, 95% CI = 1.6-4.1). These risk factors may help to identify pa tients with poorly controlled asthma in need of more intensive and com prehensive management. (C) 1998 Elsevier Science Inc.