Evidence map›Paper›PMID 25922104›Full record

Observational studyBMJ open2015

Multicentre observational study of adults with asthma exacerbations: who are the frequent users of the emergency department in Japan?

Hiroko Watase, Yusuke Hagiwara, Takuyo Chiba, Carlos A Camargo, Kohei Hasegawa, Japanese Emergency Medicine Network Investigators

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. Factors Predicting Recovery From Asthma Exacerbations.Allergy, asthma & immunology research · 2016
    Article
  6. Observational
  7. Clinical characteristics of asthmatic patients with influenza-like illness and risk of severe exacerbations in Mexico.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Hiroko WataseDepartment of Radiology, University of Washington, Seattle, Washington, USA.
Yusuke HagiwaraDepartment of Radiology, University of Washington, Seattle, Washington, USA Department of Emergency Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Takuyo ChibaDepartment of Radiology, University of Washington, Seattle, Washington, USA Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Carlos A CamargoDepartment of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Kohei HasegawaDepartment of Radiology, University of Washington, Seattle, Washington, USA Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Japanese Emergency Medicine Network Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEmergency department (ED) visits for asthma exacerbation reflect a failure of longitudinal asthma management. However, little is known about the characteristics of patients with frequent ED visits (≥2 visits in a 1-year period). We aimed to characterise the adult patients who frequently presented to the ED for asthma exacerbation in Japan.

designA multicentre chart review study of 23 EDs across Japan.

participantsAdults aged 18-54 years who presented to the ED with asthma exacerbation from 2009 to 2011. OUTCOME MEASURES: Frequency of ED visits for asthma exacerbation in a 1-year period, including the index ED visit.

resultsOf the 1002 eligible patients, 218 (22%) had frequent ED visits, accounting for 48% of total ED visits for asthma exacerbation in the 1-year period. Specifically, 12% had 2 ED visits and 10% had ≥3 visits. In these patients, guideline-recommended chronic management was suboptimal. For example, among patients with ≥3 ED visits, only 63% were treated with inhaled corticosteroids and 49% were current smokers. In a multinomial logistic regression model, markers of chronic asthma severity (history of hospitalisation for asthma and use of inhaled corticosteroids) were significantly associated with a higher frequency of ED visits (both p<0.05).

conclusionsThis multicentre study in Japan demonstrated that many patients are frequent ED users for asthma exacerbation. We also found that their asthma control management is suboptimal, most likely contributing to worse chronic severity and more frequent ED visits. Further dissemination and adoption of evidence-based guidelines are required to reduce asthma morbidity in this high-risk population.

Indexed as

Adrenal Cortex HormonesAdultAsthmaChronic DiseaseDisease ManagementEmergency Service, HospitalFemaleGlucocorticoidsHospitalizationHumansJapanLogistic ModelsMaleMiddle AgedYoung AdultAdrenal Cortex HormonesGlucocorticoidsasthma exacerbationemergency departmentinhaled corticosteroidsmulticenter studyrisk factors

Identifiers

PMID25922104
PMCPMC4420980

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.