Analysis of Patients Admitted for Asthma Exacerbation in a Tertiary Hospital in Spain

Objectives: To analyze the characteristics of adult patients admitted for asthma exacerbation and determine optimization, treatment adherence, and follow-up in clinics. Methods: Patients >= 18 years old admitted from May 2021 to June 2023 with a primary diagnosis of asthma exacerbation were included. Patients with a secondary diagnosis of asthma exacerbation and those without a confirmed diagnosis were excluded. Results: A total of 186 patients were analyzed, 63% were female, with a mean age of 49 +/- 34 years, mean body mass index (BMI) of 26.4 +/- 5 kg/m2, mean immunoglobulin E level of 132 +/- 235 IU/mL (range: 25-2041), mean eosinophils count of 180 +/- 443, and length of stay of 8.6 +/- 5 days. Comparing patients with one admission to those with multiple admissions, differences were observed in age (39 +/- 15 vs. 58 +/- 20, p < 0.0001), BMI (25.2 +/- 3 vs. 27.4 +/- 4, p < 0.0003), comorbidity (15% vs. 60%, p < 0.0001), and length of stay (4.5 +/- 2 vs. 11 +/- 3, p < 0.0001). Of the patients, 15% had undiagnosed asthma, 28% had known asthma without maintenance therapy, 23% were managed by primary care, and 34% were followed by pneumology. The mean Test of Adherence to Inhalers (TAI) score was 42.5 +/- 8 points, with 70% showing erratic non-adherence, 46% showing deliberate non-adherence, and 21% showing unconscious non-adherence. Conclusions: The young population represents a significant percentage of admissions for asthma exacerbation due to poor follow-up in pulmonology clinics, inadequate treatment optimization, and low adherence. This study adds that it is necessary to improve the approach to asthma in primary care to optimize treatment, reduce under-diagnosis, and avoid hospital admissions.