期刊
CANADIAN JOURNAL OF RESPIRATORY CRITICAL CARE AND SLEEP MEDICINE
卷 5, 期 5, 页码 276-282出版社
TAYLOR & FRANCIS INC
DOI: 10.1080/24745332.2020.1727301
关键词
Thunderstorm asthma; allergic asthma; rhinitis; ryegrass
资金
- Medical Research Future Fund through the Rapid Applied Research Translation impact fund
The study found that thunderstorm asthma mainly affects patients with seasonal allergic rhinitis, sensitized to ryegrass pollen, and some without a history of asthma. Patients requiring hospitalization typically had a history of asthma, uncontrolled symptoms, allergic rhinitis, high blood eosinophil count, and lower lung function.
RATIONALE: On November 21, 2016 in Australia, a major thunderstorm-asthma epidemic struck Melbourne with an unprecedented number of emergency presentations, hospital admissions and fatalities. OBJECTIVES: We identified affected patients who presented to The Royal Melbourne Hospital, an adult tertiary center in North-West Melbourne. We aimed to characterize individual patient factors associated with hospital admission and identify biomarkers in patient subgroups that are at risk of being severely affected by thunderstorm-asthma. METHODS: Cross-sectional, retrospective analysis of demographics of 240 patients presenting to The Royal Melbourne Hospital on November 21 to 22, 2016 post thunderstorm-asthma event and clinical characteristics of 70 of those patients who subsequently attended an outpatient clinic review. RESULTS: Patients were generally young adults (mean age 35 years), with seasonal rhinitis (96%) and universally (100%) sensitized to ryegrass pollen. Forty-four patients (63%) had a known diagnosis of asthma while 20% reported no previous diagnosis but had symptoms consistent with asthma. Patient characteristics associated with hospitalization were: uncontrolled asthma symptoms in the month before the thunderstorm-asthma event, symptomatic allergic rhinitis, high blood eosinophilia and lower lung function. CONCLUSION: Thunderstorm-asthma affects people with seasonal rhinitis, ryegrass sensitization and can occur without prior history of asthma, with dramatic potential to inundate a healthcare system. Our data suggests that hospitalization, and thus a more severe thunderstorm-asthma exacerbation, was associated with a known history of asthma, prior uncontrolled asthma symptoms, allergic rhinitis, high eosinophil count and lower lung function. These factors may inform strategies to identify those most at risk of thunderstorm-asthma.
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