Women more likely to be hospitalised after asthma emergency care

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US research shows that women who attend the emergency department (ED) with acute asthma are almost twice as likely to be admitted to hospital than men despite several measures of asthma control, treatment and severity being more favourable in women.

“These findings continue to reflect the inadequacy of current clinical and public health measures to manage female patients with asthma”, the researchers write in the Annals of Allergy, Asthma & Immunology.

The team, led by Rose Chasm (University of Maryland, Baltimore), studied the medical records of 2000 patients who attended one of 48 US EDs in 2011 and 2012, 59% of whom were female.

They found that 20% of women were hospitalised compared with only 12% of men, despite men being more likely than women to be classified as having severe or very severe asthma based on their initial peak expiratory flow (PEF) value.

By contrast, women were more likely than men to be classified as having mild or moderately severe asthma based on their initial PEF values.

And the significant differences between men and women continued after adjustment for demographical factors, such as age or race, body mass index, and factors associated with poor asthma control, including history of ED visits, registration with a primary care physician, current use of oral or inhaled corticosteroids and smoking.

The researchers say that their results echo those of earlier ED studies and suggest the reasons for the findings are probably multifactorial. These could include differences in perception of airflow obstruction or bronchial hyperresponsiveness between men and women, and the influence of female hormones.

“Awareness of the aspects of asthma unique to women should stimulate collaborative research to determine the underlying mechanisms and establish effective, individualized asthma management strategies”, Chasm and co-authors conclude.

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