To Determine the Outcome and Progression of Patients Presenting with Acute Severe Asthma at a Tertiary Care Hospital in Karachi, Pakistan

Abstract

Objectives: The aim of our study is to determine the outcome and progression of patients presenting with acute severe asthma (status asthmaticus) at a tertiary care hospital in Karachi, Pakistan. Setting: The type of study is a cross sectional study. Period: Two years from January 2013 to December 2015. Place of study: Tertiary care hospital in Karachi Pakistan, Methods: Consisted of 40 patients who were all admitted to the hospital with acute severe asthma. All the patients underwent strict clinical evaluation to assess the various aspects of the illness including the severity and complications. Data was analyzed using SPSS version 23. Results: Of the total n= 40 patients included in our study, 8 (20%) were males and 32 (80%) were females having a mean age of 52.5 +/- 20.4 years, Hypertension was the most common underlying co morbidity observed in 10 (25%) patients. The mean blood pH was found to be 7.33 +/- 0.12 at the time of presentation with a range of 6.96 to 7.57 respectively, respiratory acidosis was found in 17 (42.5%) of the patients.  A total of 29 (72.5%) patients required ventilator support out of which 14 (35%) required invasive ventilator support and 15 (37.5%) required a noninvasive ventilator support. Acidaemia was found to have a significant association with the requirement for invasive mechanical ventilation (p value of less than 0.033) also the mean duration of hospital stay was also higher in patients who required ventilator support. Conclusion: According to the results of our study, acidemia is the most severe complication of acute severe asthma, and has a significant association with increased rate of need for artificial ventilation, complication and mortality respectively.