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Master Thesis

Exacerbations d'asthme aux urgences du CHU de Guadeloupe en 2011 : gravité et devenir

Abstract : Introduction: In Guadeloupe, asthma is a real public health issue. The purpose of this study was to describe the clinical features of patients going to the adult Emergency of Guadeloupe’s public hospital for asthma exacerbations, as well as to seek severity factors and study their prospects. Patients and methods: In this retrospective, observational study, 258 passages of 200 different patients at the adult Emergency of the Point-à-Pitre/Abymes general hospital were identified from 1 January 2011 to 31 December 2011. Results: Patients’ average age was 38, including a majority of women (61%). Patients going to Emergency were mainly younger (45,5% aged between 14 and 30 versus 11,5% aged above 65). 51% of these patients have persisting asthma and 4,5% a reanimation history. 36,4% have a background therapy. A majority of patients consulted once a year at Emergency (84%), 10,5% went twice. More than 30% of the patients of this cohort presented an acute severe asthmaseverity criteria on arrival at Emergency. In bivariate analysis, AAS is a statistically significant factor of risk for hospitalisation(p<0,001). The average age for AAS is younger than for non-severe asthmas (31 versus 40 years old, p=0,13). There is no significant difference between gender, the presence of a background therapy, infectious or allergic triggering factors between AAS and non-severe asthma different groups. The majority of patients could go home after care by the SAU (80,5%), 18,5% were hospitalised in a medical service and 1,6% in an intensive care unit or reanimation. An infectious triggering factor has a significant impact (p=0,01) regarding hospitalisation compared to going back home. Conclusions: This study reflects a remaining insufficient management of asthmatics in Guadeloupe, and a high prevalence of asthma in this department among often under-cured patients. It underlines the need to strengthen actions of continuing medical training clinically, and the necessity to establish an epidemiological health watch.
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Master Thesis
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Vincent Bouzat. Exacerbations d'asthme aux urgences du CHU de Guadeloupe en 2011 : gravité et devenir. Médecine humaine et pathologie. 2015. ⟨dumas-01286935⟩

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