Prognostic nomogram for inpatients with asthma exacerbation

Wakae Hasegawa,Yasuhiro Yamauchi Email author,Hideo Yasunaga,Hideyuki Takeshima,Yukiyo Sakamoto,Taisuke Jo,Yusuke Sasabuchi,Hiroki Matsui,Kiyohide Fushimi and Takahide Nagase

Abstract

Background

Asthma exacerbation may require a visit to the emergency room as well as hospitalization and can occasionally be fatal. However, there is limited information about the prognostic factors for asthma exacerbation requiring hospitalization, and no methods are available to predict an inpatient’s prognosis. We investigated the clinical features and factors affecting in-hospital mortality of patients with asthma exacerbation and generated a nomogram to predict in-hospital death using a national inpatient database in Japan.

Methods

We retrospectively collected data concerning hospitalization of adult patients with asthma exacerbation between July 2010 and March 2013 using the Japanese Diagnosis Procedure Combination database. We recorded patient characteristics and performed Cox proportional hazards regression analysis to assess the factors associated with all-cause in-hospital mortality. Then, we constructed a nomogram to predict in-hospital death.

Results

A total of 19,684 patients with asthma exacerbation were identified; their mean age was 58.8 years (standard deviation, 19.7 years) and median length of hospital stay was 8 days (interquartile range, 5–12 days). Among study patients, 118 died in the hospital (0.6%). Factors associated with higher in-hospital mortality included older age, male sex, reduced level of consciousness, pneumonia, and heart failure. A nomogram was generated to predict the in-hospital death based on the existence of seven variables at admission. The nomogram allowed us to estimate the probability of in-hospital death, and the calibration plot based on these results was well fitted to predict the in-hospital prognosis.

Conclusion

Our nomogram allows physicians to predict individual risk of in-hospital death in patients with asthma exacerbation.

Download PDF

(You must be logged in to add and reply comments)

Interasma on Twitter

Interasma Top story: Vitamin D, the Sunshine Supplement, Has Shadowy Money Behind It https://t.co/wOlRsBJDir, see more https://t.co/CpGiFuOOYd
3hreplyretweetfavorite
Interasma Interasma - Secondhand Smoke Exposure in Childhood and Adulthood in Relation to Adult Mortality Among Never Smokers https://t.co/OiRAEbm3ti
5hreplyretweetfavorite
Interasma Interasma - Age and African-American race impact the validity and reliability of the asthma control test in persist… https://t.co/uwJyO07bis
5hreplyretweetfavorite
Interasma RT @Aller_MD: Autoinjectors are in especially high demand as the new school year begins. Reports of a shortage of EpiPens have been surfaci…
16hreplyretweetfavorite
Interasma RT @Aller_MD: Top story: Child passive smoking 'increases chronic lung risk' - BBC News https://t.co/nga9azowZF, see more https://t.co/jgCe
16hreplyretweetfavorite

Editor: Juan C. Ivancevich, MD

Copyright © Interasma 2003-2017  •  Terms of Use  •  Privacy Policy  •  Contact Us  •  Sitemap

Powered by FREI SA

InterAsma