Asthma and lower airway diseaseAge-related differences in clinical outcomes for acute asthma in the United States, 2006-2008
Section snippets
Study design and setting
We conducted a retrospective cohort study using data from the 2006-2008 Nationwide Emergency Department Sample (NEDS),13 a component of the Healthcare Cost and Utilization Project (HCUP) sponsored by the AHRQ. The HCUP-NEDS is nationally representative of all community hospital-based EDs in the United States, which is defined by the American Hospital Association as all nonfederal, short-term, general, and other specialty hospitals.14 The NEDS was constructed by using administrative records from
Patient and ED characteristics
The 2006-2008 NEDS sample contained 1,195,113 ED visits for asthma from 1,813 US EDs. After the weighting procedures, there were an estimated 1,813,000 visits annually for asthma from approximately 4,700 US EDs. In the weighted analysis the mean age of patients making these visits was 29 years, and 55% were made by women. Eighteen percent were admitted to the hospital, and the mean of their hospital LOS was 3.5 days. On average, the estimated overall number of in-hospital asthma-related deaths
Discussion
In this nationally representative sample of more than 1 million ED visits by patients with acute asthma, we found that older patients had higher ED and overall mortality, higher ED and overall charges, higher admission rates, and longer hospital LOS compared with younger adults. These findings were partially explained by differences in comorbidities; however, in multivariable and sensitivity analyses older age remained a strong predictor of higher morbidity and mortality in ED patients with
References (55)
- et al.
Sex differences in the presentation and course of asthma hospitalizations
Chest
(2006) - et al.
A prospective multicenter study of factors associated with hospital admission among adults with acute asthma
Am J Med
(2002) - et al.
Asthma exacerbations in North American adults: who are the “frequent fliers” in the emergency department?
Chest
(2005) - et al.
Quality of care for acute asthma in 63 US emergency departments
J Allergy Clin Immunol
(2009) - et al.
Asthma in the elderly: Current understanding and future research needs-a report of a National Institute on Aging (NIA) workshop
J Allergy Clin Immunol
(2011) - et al.
Methodological considerations, such as directed acyclic graphs, for studying “acute on chronic” disease epidemiology: chronic obstructive pulmonary disease example
J Clin Epidemiol
(2009) - et al.
Costs of asthma in the United States: 2002-2007
J Allergy Clin Immunol
(2011) - et al.
Asthma severity, atopic status, allergen exposure and quality of life in elderly persons
Ann Allergy Asthma Immunol
(2001) - et al.
Asthma in older adults: observations from the epidemiology and natural history of asthma: outcomes and treatment regimens (TENOR) study
Ann Allergy Asthma Immunol
(2006) - et al.
Underdiagnosis and undertreatment of asthma in the elderly. Cardiovascular Health Study Research Group
Chest
(1999)
Asthma in older adults
Lancet
Burden of concomitant asthma and COPD in a Medicaid population
Chest
Impaired bronchodilator response to albuterol in healthy elderly men and women
Chest
Advancing asthma care: the glass is only half full!
J Allergy Clin Immunol
Profile of near-fatal asthma in an inner-city hospital
Chest
Defining asthma phenotypes: focusing the picture
J Allergy Clin Immunol
Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program
J Allergy Clin Immunol
Severe asthma: an overview
J Allergy Clin Immunol
Multicenter study of cigarette smoking among patients presenting to the emergency department with acute asthma
Ann Allergy Asthma Immunol
National surveillance for asthma—United States, 1980-2004
MMWR Surveill Summ
A prospective multicenter study of patient factors associated with hospital admission from the emergency department among children with acute asthma
Arch Pediatr Adolesc Med
Sex differences among adults presenting to the emergency department with acute asthma. Multicenter Asthma Research Collaboration Investigators
Arch Intern Med
Status of childhood asthma in the United States, 1980-2007
Pediatrics
Prospective multicenter study of acute asthma in younger versus older adults presenting to the emergency department
J Am Geriatr Soc
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Supported by grant no. R03HS020722 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
Disclosure of potential conflict of interest: C. A. Camargo, Jr, is a consultant for Dey, Genentech, Merck, Novartis, and Pfizer and has received research support from GlaxoSmithKline and Sanofi-Aventis. The rest of the authors declare that they have no relevant conflicts of interest.