Precipitating factors and outcome of acute asthma attack patients attended to the emergency unit at Cairo University Specialized Pediatric Hospital in 2019 “before COVID era”

Abstract

Abstract Background Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families, and the community. Objectives The aim of this study was to find a correlation between precipitating factors of acute asthma attacks of patients attending to emergency departments and different factors such as socioeconomic status. Methods The study included patients 2–12 years old of both sexes who were already diagnosed with bronchial asthma coming to ER with acute asthmatic attacks. Data were collected by a questionnaire which includes personal data (name, age, and sex), anthropometric data, score for assessment of socioeconomic status (SES), symptoms of asthmatic attack, risk factors, mode and type of treatment, compliance to treatment, or evaluation of asthma severity and outcome of patients attending to ER. Results This study included 170 patients. Males represented 63.5% of the patients. The mean age of the patients was 5.4 ± 2.7 years. Our patients were distributed into the following: 65.9% were low SES, 22.9% were very low SES, and 11.2% were moderate SES. As regards presenting symptoms of the study group, all the patients (100%) presented to ER with cough, while 88.2% of them presented with wheezes, 85.8% presented with dyspnea, 21.2% of them presented with tightness, and only 0.01% presented with cyanosis. As regards precipitating factors of asthma, the most common precipitating factors among our patients causing attending to ER were irritant inhalers (72.4%), passive smoking (60.6%), exercise (70.5%), certain foods (45.3%), upper respiratory tract infection (12.9%), and non-compliance to asthma treatment (85.2%). The most common causes of non-compliance to treatment were family negligence and illiteracy (34.1%) and poor socioeconomic conditions (17.1%). The majority of patients (96.5%) who could be stabilized with medications were discharged, whereas a merged proportion of critically ill patients (3.5%) required ICU admission. However, no deaths were reported. Conclusion The most common precipitating factors of our patients that led to more attending to ER in the previous 6 months were exercise, irritant inhalers, and non-compliance to asthma treatment.

Keywords

• Precipitating factors
• Acute asthma attack
• Emergency unit