[Prognostic value and accuracy of crisis indicators in severe asthma].

OBJECTIVE

The objective of this study was to evaluate the predictive index of several scores such as the Scarfone score. Wood-Downes modified by Ferrés and transcutaneous oxygen saturation. (Stc,O2) for the detection of severe asthma exacerbations.

PATIENTS AND

METHODS

A transverse study design was used. Sixty patients under 15 years of age admitted consecutively with acute asthma were included in the study. We evaluated the relation (Pearson "r" correlation), precision (sensibility and specificity) and odds ratio (logistic regression) of the scores and Stc,O2 with the number of salbutamol doses required by the patients during their hospitalization.

RESULTS

The number of doses of bronchodilator needed to revert acute asthma relates to the hospital stay (r = 0.74, p < 0.0002), to all the scores taken into account (r > 0.65, 0 < 0.001) an to the Stc,O2 (r = -0.66, p < 0.001). The evaluated scores are prognostic factors for severe acute asthma, while heart rate and respiratory rate did not predict severe acute asthma.

CONCLUSIONS

We have to identify, treat and classify as having severe acute asthma those patients who after receiving three doses of inhaled bronchodilator show a Scarfone score over 10 or a Ferrés score over 8, these being situations related to an increased need of bronchodilator therapy and a longer hospital stay.