0
Original Research |

Asthma Presentations by Adults to Emergency Departments in Alberta, Canada: A Large Population-Based Study

Brian H. Rowe, MD, FCCP; Donald C. Voaklander, PhD; Dongsu Wang, MSc; Ambikaipakan Senthilselvan, PhD; Terry P. Klassen, MD; Thomas J. Marrie, MD; Rhonda J. Rosychuk, PhD*
Author and Funding Information

*From the Department of Emergency Medicine (Dr. Rowe), School of Public Health (Drs. Voaklander and Senthilselvan), Department of Pediatrics (Ms. Wang, Dr. Klassen, and Dr. Rosychuk), and Department of Medicine (Dr. Marrie), University of Alberta, Edmonton, AB, Canada.

Correspondence to: Rhonda J. Rosychuk, PhD, PStat, Department of Pediatrics, University of Alberta, 9423 Aberhart Centre, 11402 University Ave NW, Edmonton, AB, T6G 2J3 Canada; e-mail: rhonda.rosychuk@ualberta.ca

*Data are presented as No. (%).

*Data are presented as No. (%) unless otherwise indicated.

This work was performed at the University of Alberta, Edmonton, AB, Canada. This work was made possible by an operating grant from the Canadian Institutes of Health Research and funding from The Lung Association, Alberta and Northwest Territories.

This study is based in part on data provided by Alberta Health and Wellness. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the government of Alberta. Neither the government nor Alberta Health and Wellness express any opinion in relation to this study.

Dr. Rowe is supported by the government of Canada as a Twenty-First Century Canada Research Chair. Dr. Rosychuk is supported by the Alberta Heritage Foundation for Medical Research as a population health investigator.

Dr. Rowe has received research funding and speaking fees from AstraZeneca, GlaxoSmithKline, and Abbott; none of the other authors declare any potential conflicts of interest.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


This work was performed at the University of Alberta, Edmonton, AB, Canada. This work was made possible by an operating grant from the Canadian Institutes of Health Research and funding from The Lung Association, Alberta and Northwest Territories.

This work was performed at the University of Alberta, Edmonton, AB, Canada. This work was made possible by an operating grant from the Canadian Institutes of Health Research and funding from The Lung Association, Alberta and Northwest Territories.

This study is based in part on data provided by Alberta Health and Wellness. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the government of Alberta. Neither the government nor Alberta Health and Wellness express any opinion in relation to this study.

This study is based in part on data provided by Alberta Health and Wellness. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the government of Alberta. Neither the government nor Alberta Health and Wellness express any opinion in relation to this study.

Dr. Rowe is supported by the government of Canada as a Twenty-First Century Canada Research Chair. Dr. Rosychuk is supported by the Alberta Heritage Foundation for Medical Research as a population health investigator.

Dr. Rowe is supported by the government of Canada as a Twenty-First Century Canada Research Chair. Dr. Rosychuk is supported by the Alberta Heritage Foundation for Medical Research as a population health investigator.

Dr. Rowe has received research funding and speaking fees from AstraZeneca, GlaxoSmithKline, and Abbott; none of the other authors declare any potential conflicts of interest.

Dr. Rowe has received research funding and speaking fees from AstraZeneca, GlaxoSmithKline, and Abbott; none of the other authors declare any potential conflicts of interest.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(1):57-65. doi:10.1378/chest.07-3041
Text Size: A A A
Published online

Background:  Asthma is a widespread disease with a prevalence of approximately 7 to 10% in adults. Exacerbations are common in the emergency department (ED) setting. The objective of this study was to describe the epidemiology of asthma presentations to EDs made by adults in the province of Alberta, Canada.

Methods:  The Ambulatory Care Classification System of Alberta and provincial administrative databases were used to obtain all ED encounters for asthma during 6 fiscal years (April 1999 to March 2005). Information extracted included demographics, ED visit timing, and subsequent visits to non-ED settings. Data analysis included descriptive summaries and directly standardized visit rates.

Results:  There were 105,813 ED visits for asthma made by 48,942 distinct adults, with an average of 2.2 visits per individual. Most patients (66%) had only one asthma-related ED visit. Female patients (61.2%) presented more commonly than male patients. The gender- and age-standardized visit rates declined from 9.7/1,000 in 1999/2000 to 6.8/1,000 in 2004/2005. The welfare and Aboriginal subsidy groups had larger age-specific ED visits rates than other populations. Important daily, weekly, and monthly trends were observed. Hospital admission occurred in 9.8% of the cases; 6.4% had a repeat ED visit within 7 days. Overall, 67.4% of individuals had yet to have a non-ED follow-up visit by 1 week. The estimated median time to the first follow-up visit was 19 days (95% confidence interval, 18 to 21).

Conclusions:  Asthma is a common presenting problem in Alberta EDs, and further study of these trends is required to understand the factors associated with the variation in presentations. The important findings include an overall decrease in the rates of presentation over the study period, disparities based on age, gender, and socioeconomic/cultural status, and the low rate of early follow-up. Targeted interventions could be implemented to address specific groups and reduce asthma-related visits to Alberta EDs.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543