Objective: To determine whether, for patients with moderate or severe asthma presenting to
emergency departments, there is a difference in need for hospitalization between those
with a duration of symptoms less than 6 h and those with a longer duration of
symptoms.
Methods: This prospective, observational study investigated a sample of patients presenting with
acute asthma between 21 August and the 3 September 2000, attending study emergency
departments and classified as having moderate or severe asthma according to the
National Asthma Guidelines. Data collected included duration of symptoms (less than
6 h or greater than 6 h) and disposition following emergency department treatment
(home, ward, intensive care unit, high dependency unit, transfer). Data analysis was by
Chi square analysis.
Results: Of 381 eligible patients, 348 had sufficient data for entry into this study (33 had missing
data). Patients with duration of symptoms more than 6 h were more likely to require
hospital admission (P < 0.0001). The relative risk for hospital admission or transfer as
opposed to discharge from the emergency department for the group with a duration of
symptoms of more than 6 h was 2.2.
Conclusion: Patients presenting with moderate or severe asthma and a duration of symptoms of more
than 6 h are more likely to require hospital admission or transfer for further treatment
than patients with a shorter duration of symptoms. This has implications for decision
making regarding asthma management and disposition in the emergency department.