Document Detail

Sudden-onset asthma exacerbations: clinical features, response to therapy, and 2-week follow-up. Multicenter Airway Research Collaboration (MARC) investigators.
MedLine Citation:
PMID:  10706490     Owner:  NLM     Status:  MEDLINE    
Sudden-onset asthma exacerbations may have different triggers and responses to treatment than slower-onset exacerbations. The authors studied this hypothesis among patients with severe asthma exacerbations. The Multicenter Airway Research Collaboration prospectively enrolled patients presenting to 64 North American emergency departments with asthma exacerbations. Of 1,847 patients aged 18-54 yrs, 900 had severe exacerbations (peak expiratory flow rate (PEFR) <50% predicted or hospitalized without PEFR). These patients were divided into sudden-onset (< or =3 h of symptoms) and slower-onset (>3 h of symptoms) groups. Fourteen per cent (95% confidence interval, 11-16%) of patients with severe asthma exacerbations had sudden-onset exacerbations. Sudden-onset patients were similar to slower-onset patients, except triggers of their exacerbations were more often respiratory allergens, exercise or psychosocial stress and less often respiratory infections. Sudden-onset patients were more likely to have used oral beta-agonists and salmeterol in the preceding 4 weeks. Although initial PEFRs and management were similar, sudden-onset patients had a greater improvement in PEFR (35 versus 28% p<0.001). Sudden-onset patients were less often discharged on systemic corticosteroids, but had similar 2-week relapse rates compared with slower-onset patients. Among patients presenting with severe asthma exacerbations, sudden-onset exacerbations had a different pattern of triggers and greater improvement with treatment than slower-onset exacerbations.
R G Barr; P G Woodruff; S Clark; C A Camargo
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The European respiratory journal     Volume:  15     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-28     Completed Date:  2000-03-28     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  266-73     Citation Subset:  IM    
General Medicine Division, Massachusetts General Hospital, Boston 02114, USA.
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MeSH Terms
Anti-Asthmatic Agents / therapeutic use
Asthma / drug therapy,  epidemiology,  etiology*
Bronchodilator Agents / therapeutic use
Cohort Studies
Follow-Up Studies
Peak Expiratory Flow Rate
Prospective Studies
Treatment Outcome
Grant Support
Reg. No./Substance:
0/Anti-Asthmatic Agents; 0/Bronchodilator Agents

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