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The 2016 Melbourne thunderstorm asthma epidemic: Risk factors for severe attacks requiring hospital admission.

Abstract：

BACKGROUND:The world's most catastrophic and deadly thunderstorm asthma epidemic struck Melbourne, Australia, on November 21, 2016. OBJECTIVE:Among thunderstorm-affected patients presenting to emergency rooms (ERs), we investigated risk factors predicting severe attacks requiring admission to hospital. METHODS:Thunderstorm-affected patients were identified from ER records at the eight major Melbourne health services and interviewed by telephone. Risk factors for hospital admission were analyzed. RESULTS:We interviewed 1435/2248 (64%) of thunderstorm-affected patients, of whom 164 (11.4%) required hospital admission. Overall, rhinitis was present in 87%, and current asthma was present in 28%. Odds for hospital admission were higher with increasing age (odds ratio 1.010, 95% CI 1.002, 1.019) and among individuals with current asthma (adjusted odds ratio [aOR] 1.87, 95% CI 1.26, 2.78). Prior hospitalization for asthma in the previous 12 months further increased the odds for hospital admission (aOR 3.16, 95% CI 1.63, 6.12). Among patients of Asian ethnicity, the odds for hospital admission were lower than for non-Asian patients (aOR 0.59, 95% CI 0.38, 0.94), but higher if born in Australia (OR = 5.42, 95% CI 1.56, 18.83). CONCLUSIONS:In epidemic thunderstorm asthma patients who presented to the ER, higher odds for hospital admission among patients with known asthma were further amplified by recent asthma admission, highlighting the vulnerability conferred by suboptimal disease control. Odds for hospital admission were lower in Asian patients born overseas, but higher in Asian patients born locally, than in non-Asian patients; these observations suggest susceptibility to severe thunderstorm asthma may be enhanced by gene-environment interactions.

journal_name

Allergy

journal_title

Allergy

authors

Hew M,Lee J,Susanto NH,Prasad S,Bardin PG,Barnes S,Ruane L,Southcott AM,Gillman A,Young A,Rangamuwa K,O'Hehir RE,McDonald C,Sutherland M,Conron M,Matthews S,Harun NS,Lachapelle P,Douglass JA,Irving L,Langton D,M

doi

10.1111/all.13609

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

122-130

issue

eissn

0105-4538

issn

1398-9995

journal_volume

pub_type

杂志文章,多中心研究

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The 2016 Melbourne thunderstorm asthma epidemic: Risk factors for severe attacks requiring hospital admission.