Profile of Acute Asthma Exacerbation in Drug Users

被引:11
|
作者
Doshi, Viral [1 ]
Shenoy, Sundeep [2 ]
Ganesh, Aarthi [2 ]
Rishi, Muhammad Adeel [3 ]
Molnar, Janos [4 ]
Henkle, Joseph [1 ]
机构
[1] Southern Illinois Univ, Sch Med, Div Pulm & Crit Care Med, POB 19636, Springfield, IL 62794 USA
[2] Univ Arizona, Tucson, AZ USA
[3] Mayo Clin, Rochester, MN USA
[4] Rosalind Franklin Univ Med & Sci, Chicago Med Sch, N Chicago, IL USA
关键词
cocaine; heroin; acute exacerbation of asthma; NEAR-FATAL ASTHMA; HOSPITALIZED-PATIENTS; SUBSTANCE-ABUSE; COCAINE; ASSOCIATION; DEATHS;
D O I
10.1097/MJT.0000000000000118
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
The characteristics of patients who use heroin, cocaine, or both and present with acute asthma exacerbations have not been well studied. In this retrospective study, we aimed to study the demographic characteristics of this patient population, the characteristics of their asthma attack, and the risk factors for the need for invasive mechanical ventilation in this patient population. We reviewed the charts of patients discharged from an inner-city hospital with a diagnosis of acute asthma exacerbation. Individuals who used either heroin or cocaine or both within 24 hours of presenting to the emergency department were identified as a cohort of drug users. The rest were classified as non-drug users. Both groups were compared, and a univariate analysis was performed. To assess the predictive value of drug use for the need for intubation in the presence of confounding factors, logistic regression analysis was performed to identify whether using cocaine or heroin or both was an individual predictor for the need for invasive ventilation. Data from 218 patients were analyzed. Drug users (n = 85) were younger (mean age in years 43.9 vs. 50.5, P < 0.01), predominantly male (63.5% vs. 33.8%, P < 0.01), and more likely to be cigarette smokers (90.6% vs. 57.6%, P < 0.01). A medical history of intubation and admissions to the intensive care unit (ICU) was more common among drug users (56.5% vs. 29.3%, P < 0.01 and 54.1% vs. 38.3%, P < 0.03, respectively). Drug use was associated with increased need for invasive mechanical ventilation (35% vs. 23.3%, P = 0.05). Non-drug users were more likely to be using inhaled corticosteroids (48.9% vs. 32.9%, P = 0.03) and had longitudinal care established with a primary care provider (50.6% vs. 68.9%, P < 0.01). After adjusting for a history of mechanical ventilation, history of ICU admission, use of systemic corticosteroids, smoking, and acute physiological assessment and chronic health evaluation 2 score, drug use remained predictive for the need for mechanical ventilation (P = 0.026). Acute asthma exacerbations triggered by cocaine and heroin should be treated aggressively because they represent a cohort with poor follow-up and undertreated asthma as outpatients and are associated with increased need for invasive mechanical ventilation and ICU admission during acute exacerbation.
引用
收藏
页码:E39 / E43
页数:5
相关论文
共 50 条
  • [11] Pneumomediastinum: A Complication of Acute Asthma Exacerbation
    Ohiokpehai, B.
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2023, 207
  • [12] THE PROFILE OF PATIENTS WITH ACUTE EXACERBATION OF ASTHMA AND COPD PRESENTING TO THE EMERGENCY ROOM: A TERTIARY HOSPITAL EXPERIENCE
    Ismail, Nahlah Elkudssiah
    Adnan, Nik Nuradlina Nik
    Abdullah, Abu Hassan Ashaari
    Wahab, Mahathar Abdul
    RESPIROLOGY, 2010, 15 : 39 - 39
  • [13] Asthma exacerbation in childhood - sputum profile and pulmonary tests
    Petrova, G.
    Miteva, D.
    Kabakchieva, R.
    Dimitrov, Z.
    Perenovska, P.
    ALLERGY, 2013, 68 : 621 - 621
  • [14] Managing the paediatric patient with an acute asthma exacerbation
    Ortiz-Alvarez, Oliva
    Mikrogianakis, Angelo
    PAEDIATRICS & CHILD HEALTH, 2012, 17 (05) : 251 - 256
  • [15] Hydrogen peroxide in acute childhood asthma exacerbation
    Rinaldi, L.
    Rico, S.
    Corchia, M.
    Calcinai, E.
    Dascola, Povesi C.
    Terracciano, L.
    Corradi, M.
    Caffarelli, C.
    ALLERGY, 2012, 67 : 477 - 477
  • [16] A simplified severity score for acute asthma exacerbation
    Dankner, R.
    Olmer, L.
    Ziv, A.
    Bentancur, A. G.
    JOURNAL OF ASTHMA, 2013, 50 (08) : 871 - 876
  • [17] Occult sinusitis in patients with an acute exacerbation of asthma
    Peters, EJ
    Crater, SE
    Phillips, CD
    Murphy, AW
    Platts-Mills, TAE
    JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1998, 101 (01) : S253 - S253
  • [18] Lymphocytes apoptosis in patients with acute exacerbation of asthma
    Hamzaoui, A
    Hamzaoui, K
    Salah, H
    Chabbou, A
    MEDIATORS OF INFLAMMATION, 1999, 8 (4-5) : 237 - 243
  • [19] Acute Promyelocytic Leukemia Masquerading As An Asthma Exacerbation
    Sathe, N. A.
    Kwok, B.
    Chitkara, N.
    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2017, 195
  • [20] ACUTE EXACERBATION OF CHILDHOOD ASTHMA FROM BROMPHENIRAMINE
    SCHULLER, DE
    ANNALS OF ALLERGY, 1983, 50 (05): : 362 - 363