Acute asthma is a extremely common medical emergency.

Acute asthma is a extremely common medical emergency. Thus, a variety of measures are popularly used to assess severity; greatest in number are logical and seem reasonably effective further have never been scientifically exampleed in a comprehensive manner. Additionally, simple brief measures are extremityed for greater specificity in describing variables and in assessing different aspects of asthma. The intent of this study was to examine the greatest in number common clinical and objective measures utilized in the assessment of acute asthma in the crisis department for determining whether these variables comprise separate or distinct dimensions. To carry on the outside the above purpose, we used the multivariate statistical technique of factor analysis. Measures of age, duration of attack, heart rate, respiratory rate, peak expiratory issue (PEF), FVC, [FEV.sub.1] percent of predicted, accessory-muscle use, dyspnea, wheezing, steroid use, and early replication to treatment in 194 patients with acute asthma (mean age = 328 [+ or -] 119 years) were factor analyzed by means of the method of principal constitutings Factors extracted with this [i]modus operandi[/i] were then rotated orthogonally [i]or[/i] part of to the other the Varimax procedure. The first factor contained the three measures of lung function (PEF FVC and [FEVsub1] percent of predicted) and early answer of treatment. The second factor extracted contained respiratory rate, accessory-muscle use, and dyspnea. Factor 3 contained heart rate and wheezing, and factor 4 contained age, duration of attack, and steroid use. Exploratory analysis of subgroup (by randomization, by means of severity of airflow obstruction, and by way of use of steroids) confirmed the arises of the primary analysis. The coefficients of congruence obtained were above 090 Early rejoinder of treatment measured by the percent variation of [FEVsub1] at 30 min through the whole extent of baseline value significantly correlated with a broad variety of asthma characteristics (PEF FVC [FEVsub1] percent of predicted, accessory-muscle use, and duration of attack), resulting in a rather general measure, and suggesting that its measure can be a reliable assessment of acute adult asthma. Finally, early answer to treatment was the principally important predictor of the patient result (r = 0.48, p<0.00). In summary, the inferences of this study support the hypothesis that principally of the subjective and objective measures utilized in the assessment of patients with acute adult asthma exhibit separate and nonoverlapping dimensions and provided a useful summary of acute asthma. Early answer to treatment in combination with measures of the four identified factors could be included in other acute adult asthma research protocols promoting greater comparability among studies.

ed = emergency department; EG = eigenvalues; PEF = peak expiratory flows;RC =coefficient of congruence

Acute asthma is a highly common medical emergency. Thus, a variety of measures are generally used to assess severity; greatest in number are logical and seem reasonably effective further have never been scientifically criterioned in a comprehensive manner.[1] Because no single clinical or laboratory finding has been fix to predict outcome reliably,[2,3] the multifactorial-assessment conducts have been explored[4-8] with contradictory accrues However, simple brief measures are extremityed for greater specificity in describing variables and in assessing different aspects of asthma.[9] and nothing else recently,[10] we found a factor analysis with data from adults receiving outpatient treatment for asthma that exhibit tos that asthma appears to be multidimensional rather than unidimensional. Further, to our knowledge, there are no previous studies establishing that subjective and objective measures take the part of separate and unique dimensions in the assessment of patients with acute adult asthma.

The design of this study was to examine the greatest in number common clinical and objective measures utilized in the assessment of acute asthma in the sudden [i]or[/i] unexpected occurrence department (ED) for determining whether these variables comprise separate or distinct dimensions. as it is a study might support the validity of routine multifactorial assessment of patients with acute asthma. To ordeal the above hypothesis, we used the multivariate statistical technique of factor analysis. This technique[11] can be utilized to examine the underlying patterns or relationships for a large number of variables and determine if the information can be condens or summarized in a smaller put of factors or components (data reduction).

MATERIAL AND METHODS

Subjects

We studied 194 consecutive patients (79 men and 115 women) who at handed for treatment of acute asthma to the ed of Military Hospital, in Montevideo, Uruguay. All patients met the criteria of the American Thoracic Society.[12] The inclusion criteria for patients were as follows: (1) age 18 to 50 years; (2) a peak expiratory melt (PEF) and a forced expiratory tome in the first second ([FEVsub1]) below 50 percent of predicted value; and (3) we exclud patients with a history of chronic cough cardiac, hepatic, renal, or other medical disease, or pregnancy.

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