Comparison of males and females presenting with acute asthma to the emergency department

Awadh, N.; Chu, Stephanie; Grunfeld, Anton; Simpson, Kirsty; FitzGerald, J. Mark

doi:10.1016/s0954-6111(96)90176-6

Cited by 31 publications

(16 citation statements)

References 10 publications

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“…In some of the countries females were more likely to be using medication against asthma than were males with comparable levels of symptoms and BHR. This is in accordance with a Canadian study that found that females were more inclined to seek emergency treatment for acute asthma [23]. Results from previous studies have shown conflicting results concerning sex differences in the use of antiasthmatic drugs.…”

Section: Discussionsupporting

confidence: 91%

Individual use of antiasthmatic drugs in the European Community Respiratory Health Survey

Janson

Chinn²,

Jarvis³

et al. 1998

Eur Respir J

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A previous analysis of drug utilization in the European Community Respiratory Health Survey found that only between 8 and 29% of subjects with asthma-related symptoms were using antiasthmatic medication in the different areas studied. The aim of this analysis was to investigate which variables were related to individual use of antiasthmatic medication in different geographical areas. Thirty-three centres in 14 countries were analysed, in which a total of 16,854 people (52.1% females, mean age 33.8 yrs, range 20-48) underwent a structured interview, measurement of specific immunoglobin E, spirometry and methacholine challenge test. The use of antiasthmatic drugs in individuals was, in most countries, independently related to asthma-related respiratory symptoms, bronchial hyperresponsiveness (BHR) and atopy. In all countries smokers with respiratory symptoms were less likely to be using antiasthmatic drugs than nonsmokers and exsmokers. In four of 14 countries females were significantly more likely to use antiasthmatic medication than males, while age and socioeconomic status were unrelated to medication. The use of inhaled anti-inflammatory drugs was positively related to symptoms, BHR and atopy and negatively related to current smoking. In conclusion, in many countries smokers were less likely to be using antiasthmatic drugs than were nonsmokers with comparable levels of symptoms and bronchial hyperresponsiveness. Age and socioeconomic status were unrelated to medication, while in some countries females were more likely than males to use antiasthmatic medication.

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Section: Discussionsupporting

confidence: 91%

Individual use of antiasthmatic drugs in the European Community Respiratory Health Survey

Janson

Chinn²,

Jarvis³

et al. 1998

Eur Respir J

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“…Although our numbers are small, this observation is supported by other work suggesting that males may be at greater risk because of precipitous declines in lung function (23). In a recent ED study, we showed that males are more likely to have severe airflow obstruction than are females at the time of presentation (FEV 1 % predicted: 49 Ϯ 20% [mean Ϯ SD] in females, versus 33 Ϯ 15% in males; p Ͻ 0.001) (24). Kikuchi and colleagues (25) have identified differences in perception among NFA patients, non-NFA patients, and controls, but they did not report a gender difference.…”

Section: Discussionsupporting

confidence: 86%

Risk Factors for Near-fatal Asthma

Turner

Noertjojo

Vedal

et al. 1998

Am J Respir Crit Care Med

245

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We prospectively recruited patients admitted to the hospital with severe asthma to comprehensively evaluate the association of historical and physiologic features with the risk of near-fatal asthma (NFA). A case-control study design was used. All patients admitted with NFA (cases) were identified prospectively and compared with asthma patients admitted during the same period without respiratory failure (controls). Nineteen cases (age: 40.2 +/- 12.0 yr) (mean +/- SD) and 80 controls (age: 36 +/- 13.5 yr) were enrolled. Duration of asthma, gender, smoking status, ethnicity, and prevalence of atopy were similar in the case and control groups. More than 80% of patients in both groups reported worsening symptoms for more than 48 h before admission, and more than 50% were worse for longer than 7 d. There was no difference in degree of airways obstruction or bronchial hyperresponsiveness (PC20). Perception of dyspnea was similar in the cases and controls, but among cases the males had greater impairment than the females (Borg score: 1.9 +/- 1. 4 versus 3.9 +/- 1.2: p = 0.05). Univariate analysis identified a history of previous mechanical ventilation (OR: 27.5; 95% CI: 6.60 to 113.7), admission to the intensive care unit (ICU) (OR: 9.9; 95% CI: 3.0 to 32.9), history of worse asthma during January and February (OR: 3.5; 95% CI: 1.0 to 11.8), and use of air-conditioning (OR: 15.0; 95% CI: 1.3 to 166) as risk factors for NFA. Of concern was the dependence of most patients (59.8%) on the emergency department (ED) for initial care, and the small number of cases (16%) in which patients visited a physician before admission to the hospital. We have confirmed risk factors identified previously in retrospective studies of fatal and NFA, and have also shown that hospitalized patients with asthma, irrespective of severity of their asthma, share several characteristics, especially in terms of their failure to respond to worsening asthma.

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“…Similar trends in hospital admissions for asthma exacerbations have been described in Canada and Europe (26,27). Women presenting to the emergency department for treatment of asthma symptoms are more likely to be admitted to the hospital than men despite presenting with better pulmonary function (17,31) and less hypercapnea (32), even after correcting for differences in asthma prevalence and smoking (33). In addition, the length of hospital stays for asthma exacerbations has been shown to be longer in women (29,32,34) than in men.…”

Section: Perception Of Symptoms and Quality Of Lifementioning

confidence: 62%

“…Female sex is an independent risk factor for suffering severe asthma exacerbations [28,30]. Women presenting to the emergency department with asthma symptoms are more likely to be admitted to the hospital than men despite having better pulmonary function [17,31] and less hypercapnea [32]. The length of hospital stays for asthma exacerbations has been shown to be longer in women than in men [29,32,34].…”

Section: Perception Of Symptoms and Quality Of Lifementioning

confidence: 99%

Sex Differences in Asthma

McCallister

Mastronarde

2008

Journal of Asthma

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Asthma is a common chronic pulmonary disease whose prevalence varies greatly with the sex and age of the patient. Research has shown that men and women may experience this disease differently, although these sex-related differences have not routinely translated into differences in clinical care for patients with asthma. This review explores some of the major differences in asthma between men and women and some of the main hypotheses developed to explain them.

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Comparison of males and females presenting with acute asthma to the emergency department

Cited by 31 publications

References 10 publications

Individual use of antiasthmatic drugs in the European Community Respiratory Health Survey

Individual use of antiasthmatic drugs in the European Community Respiratory Health Survey

Risk Factors for Near-fatal Asthma

Sex Differences in Asthma

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