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ICD Code: 493. Asthma



ICD Code: 493. Article Review
Title: "National Asthma Attack Audit 1991-2." BMJ; V.306; 2/27/93; p559
      STUDY DESIGN: A study was done to describe the frequency, characteristics, and management of asthma attacks in the United Kingdom. 218 general practices were surveyed that included 1775 asthma patients of all ages who had a total of 1805 asthma attacks over three months.
      FREQUENCY AND MANAGEMENT: The estimated frequency of attacks in a general practice community of 250,739 patients was 14.3 per 1000 patients per year. Of the 1805 attacks occurring during the study period, 300 occurred in boys aged 0-9, 144 in girls aged 0-9, and 118 in women aged 20-29. 86% of patients with attacks were managed within general practice, 12% were admitted to the hospital, and 2% were discharged from the emergency department. Two patients died; both occurred outside the hospital. Five patients (2% of those admitted to hospital) were mechanically ventilated in an intensive care unit.
      CLINICAL PRESENTATION AND MEDICATION: On initial presentation, 14% of patients were not breathless, 50% were moderately breathless, 30% were breathless and distressed, 4% were too breathless to talk and 2 patients were moribund. Underuse of nebulized bronchodilators and systemic steroids was apparent in all grades of clinical severity. Contrary to current guidelines for asthma management, "step up" in maintenance therapy after an attack was often not practiced.

Search Criteria: Text - BMJ; V.306; 2/27/93; p559