REAUDIT OF ACUTE ASTHMA ADMISSIONS USING A SEVERITY MARKER STAMP AND DETERMINANTS OF AN OUTCOME MEASURE

Subsequent to the implementation of a severity marker stamp in case no tes, an audit was performed in 86 admissions with acute asthma to a sp ecialist centre over a 12 month period. Compared to previous audit the documentation of severity markers was significantly better (PEFR: 52% vs 83% p=0.001, Respiratory rate: 44% vs 81% p=0.001, ABG: 72% vs 80% p=0.04, air entry: 58% vs 86% p=0.001, speech: 27% vs 86% p=0.001, ex haustion: 4% vs 86% p=0.001). In contrast to the previous audit where no patient received FiO2 > 0.35, 66% of the cases in the repeat audit received FiO2 0.60 (p=0.001). The mean duration of admission was five days and showed highest partial correlation (r=0.6) to the time in hou rs for the pulse to fall to 80/min. Multiple linear regression showed that this was the only variable best predicting the duration of admiss ion (R-2=0.3). Admission pulse rate (p=0.04) and serum K+(p=0.04) best discriminated between patients admitted for over and under five days. Logistic regression identified only the admission pulse as significan t in calculating the odds of the patient staying in the hospital for > 5 days.