Improved outcomes from acute severe asthma in Australian intensive care units (1996 - 2003)

Peter J Stow ¹, David V Pilcher ^2*, John Wilson ³, Carol George ⁴, Michael Bailey ⁵, Tracey Higlett ⁶, Rinaldo Bellomo ⁷ and Graeme K Hart ⁷

¹ Department of Intensive Care, Geelong Hospital, Geelong, Victoria, Australia
² The Alfred Hospital, Melbourne, Australia
³ Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Australia
⁴ Australia and New Zealand Intensive Care Society (ANZICS) Adult Patient Database, Melbourne, Australia
⁵ Department of Epidemiology and Preventive Medicine, Monash University, Prahran , Victoria, Australia
⁶ ANZICS Research Centre for Critical Care Resources, Australia
⁷ Department of Intensive Care, Austin Hospital, Melbourne, Australia

^* To whom correspondence should be addressed. E-mail: d.pilcher{at}alfred.org.au.

Accepted 5 March 2007

Abstract

Background: There is limited information on changes in the epidemiology and outcome of patients with asthma admitted to intensive care units (ICUs) in the last decade. A database sampling intensive care activity in hospitals throughout Australia offers the opportunity to examine these changes

Methods: We interrogated the Australian and New Zealand Intensive Care Society Adult Patient Database for all patients with asthma admitted to ICU from 1996 to 2003. Demographic, physiological and outcome information was obtained and analysed from 22 hospitals which had submitted data continuously over this period.

Results: ICU admissions with the primary diagnosis of asthma represented 1,899 (1.5%) of 126,906 admissions during the 8 year period. 36.1% received mechanical ventilation during the first 24 hours. The overall incidence of admission to ICU fell from 1.9% in 1996 to 1.1% in 2003 (p<0.001). Overall hospital mortality was 3.2%. There was a significant decline in mortality from a peak of 4.7% in 1997 to 1.1% in 2003 (p=0.014). This was despite increasing severity of illness (as evidenced by an increasing predicted risk of death derived from the APACHE II score) over the 8 year period (p=0.002).

Conclusions: There has been a significant decline in the incidence of asthma requiring ICU admission between 1996 and 2003 among units sampled by the Australian and New Zealand Intensive Care Society Adult Patient Database. The mortality of these patients has also decreased over time and is lower than reported in other studies.

Keywords: Asthma, Critical care, Database, Mortality, Trend

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Airwaves

Wisia Wedzicha
Thorax 2007 62: 837. [Extract] [Full Text] [PDF]