Chest
Clinical InvestigationsAsthmaProspective Multicenter Study of Relapse Following Treatment for Acute Asthma Among Adults Presenting to the Emergency Department
Section snippets
Subjects
This study combines data from two prospective cohort studies performed during October 1996 to December 1996 and April 1997 to June 1997, respectively, as part of the Multicenter Asthma Research Collaboration (MARC).17 This study was designed prospectively to evaluate a number of aspects of ED asthma care, including relapse. Using a standardized protocol, investigators at 36 EDs in 18 states provided 24 h/d coverage for a median of 2 weeks and enrolled 1,281 patients with acute asthma. All
Results
During the study period, 1,301 patients were discharged from the ED with a diagnosis of asthma; 939 of these patients were evaluated for the study. The patients who were not enrolled did not differ from the study population by either age or gender. A total of 641 patients sent home from the ED had complete follow-up data. These patients, compared with those not contacted by telephone (n = 297), did not differ significantly according to age, asthma medications used in past 4 weeks, number of
Discussion
This study confirms previous findings that a substantial proportion of patients treated in the ED suffer a relapse within days to weeks after ED discharge. Although there is no common definition of an “acceptable” relapse rate, 17% certainly represents a high failure rate. In this study, we have confirmed that easily ascertainable historical features define patients at highest risk. Since the National Asthma Education and Prevention Program guidelines allow for physician discretion in the
MARC Steering Committee
Carlos A. Camargo, Jr., MD, FCCP (Chair); Rita K. Cydulka, MD; Michael A. Gibbs, MD; Robert A. Silverman, MD; and Janice L. Zimmerman, MD, FCCP.
Operations Committee and Data Coordinating Center
Carlos A. Camargo, Jr., MD, FCCP (Chair); George T. Mathew; Leo T. Mayer; Anita K. Singh; and Prescott G. Woodruff, MD—all at Massachusetts General Hospital, Boston, MA.
Principal Investigators at the 36 Participating Sites
C.A. Bethel (Mercy Hospital, Philadelphia, PA); L. Bielory (University Hospital, Newark, NJ); M.P. Blanda (Summa Health System, Akron, OH); B.E. Brenner (Brooklyn Hospital Center,
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Cited by (0)
Drs. Woodruff and Camargo are supported by grants HL-07427 and HL-03533, respectively, from the National Institutes of Health (Bethesda, MD). The Multicenter Asthma Research Collaboration is supported by unrestricted grants from Glaxo-Wellcome Inc (Research Triangle Park, NC) and Monaghan Medical Corporation (Syracuse, NY).
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A complete list of the MARC Investigators is located in Appendix1.