Risk factors precipitating exacerbations in adult asthma patients presenting at Kalafong Hospital, Pretoria : original research
Notice bibliographique
Résumé
Background : Research into asthma is proceeding at an unprecedented rate and yet we live with a disease that escalates in prevalence and severity, despite a greater understanding of its pathophysiology and the necessary therapy. The total prevalence of asthma is estimated to lie at 7.2% of the world's population (6% in adults, 10% in children). Data from Australia, Canada and Spain report that acute asthma accounted for 1 to 12% of all adult emergency department visits. The prevalence of asthma in South Africa lies at 5% for adults and 10% for children. Asthma is reported as taking up 1 to 2% of the total health budget in direct costs, with equally large indirect costs being incurred for time lost from work and reduced productivity. It has also been reported that approximately one-third of the direct care costs of asthma are attributable to emergency department visits and hospitalisations. In some cases, exposure may be unavoidable (for example exposures to cold air, exercise or the asthma-inducing effects of pregnancy). Many studies have been done in other countries on specific triggers, especially allergens and viral respiratory infections. However, circumstances differ in the public sector in South Africa and other factors such as compliance and under-treatment, which may be applicable, should be studied in contention. Methods : A matched case-control study was undertaken matched on age and gender between December 2003 and May 2005. Known asthma patients with exacerbations presenting at Kalafong Hospital's emergency unit were chosen as cases. Controls were stable asthma patients recruited from the outpatient departments. A structured questionnaire was used to interview patients concerning their possible exposure to certain triggers and risk factors. Univariate and multivariate analyses with conditional logistic regression were done to determine any significant exposures. Participants were between 18 and 65 years of age. Results : In total, 356 patients were evaluated. Fifty cases and 100 controls were enrolled. Cases were shown to be more non-compliant than controls (OR = 2.18; 95% Confidence interval (CI): 1.09 to 4.38, p = 0.03). Missing follow-up doctor's appointments for the last six months were statistically significant with an OR of 2.39 (95% CI 1.08 to 5.27) and p = 0.03. Conclusions : Non-compliance was a strong predictor of exacerbations in adult asthma patients at Kalafong Hospital.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,004 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».