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Circadian patterns of emergency asthma presentations: implications for staffing and treatment.
Respir Care. 1995 Jun; 40(6):624-30.RC

Abstract

Are there circadian patterns for time of presentation and clinical status in asthmatic patients admitted to an emergency department for acute exacerbations?

DESIGN

Prospective observational study.

SETTING

Urban community teaching hospital emergency department.

PARTICIPANTS

279 consecutive patients who presented a total of 310 times with asthma exacerbations between October 19 and December 31, 1993. We grouped patients aged 16 years and above as adults and patients younger than 16 years of age as children. INFORMATION COLLECTED: Time of emergency department presentation, time attack began (for adult patients), peak expiratory flowrate prior to emergency department treatment (for adult patients), need for hospital admission, ventilatory failure during an acute attack, and death during an acute attack.

RESULTS

Circadian patterns were demonstrated for time of presentation. For the total study group, the peak time of presentation was 8:00 PM to 11:59 PM (p < 0.05) and the trough time of presentation was 4:00 AM to 7:59 AM (p < 0.01). There were differences in peak time of presentation for patients grouped by age. For adult patients only, the peak time of presentation was 8:00 AM to 11:59 AM (p < 0.01), whereas for children only, the peak time of presentation was 8:00 PM to 11:59 PM (p < 0.001). No statistically significant patterns in time of attack onset, hospital admission rates, or peak flow measurements were observed.

CONCLUSIONS

There are circadian patterns for the time at which patients with acute asthmatic exacerbations present to our emergency department. Adult patients have a peak time of presentation between 8:00 AM and 11:59 AM, whereas children have an apparent peak time of presentation between 8:00 PM and 11:59 PM. For all age groups, there is a trough in presentation between 4:00 AM and 7:59 AM.

Authors+Show Affiliations

Buff DD
St John's Episcopal Hospital, Far Rockaway, NY 11691, USA.
Bavli SZ
No affiliation info available
Bloch MH
No affiliation info available
Serebryansky BM
No affiliation info available
Aman CS
No affiliation info available

MeSH

AdultAsthmaChildCircadian RhythmData CollectionEmergency Service, HospitalEpisode of CareFemaleHospitals, TeachingHumansIncidenceMaleMedical Staff, HospitalNew YorkProspective StudiesTime FactorsWorkforce

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10143508

Citation

Buff, D D., et al. "Circadian Patterns of Emergency Asthma Presentations: Implications for Staffing and Treatment." Respiratory Care, vol. 40, no. 6, 1995, pp. 624-30.
Buff DD, Bavli SZ, Bloch MH, et al. Circadian patterns of emergency asthma presentations: implications for staffing and treatment. Respir Care. 1995;40(6):624-30.
Buff, D. D., Bavli, S. Z., Bloch, M. H., Serebryansky, B. M., & Aman, C. S. (1995). Circadian patterns of emergency asthma presentations: implications for staffing and treatment. Respiratory Care, 40(6), 624-30.
Buff DD, et al. Circadian Patterns of Emergency Asthma Presentations: Implications for Staffing and Treatment. Respir Care. 1995;40(6):624-30. PubMed PMID: 10143508.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Circadian patterns of emergency asthma presentations: implications for staffing and treatment. AU - Buff,D D, AU - Bavli,S Z, AU - Bloch,M H, AU - Serebryansky,B M, AU - Aman,C S, PY - 1995/6/1/pubmed PY - 1999/4/2/medline PY - 1995/6/1/entrez SP - 624 EP - 30 JF - Respiratory care JO - Respir Care VL - 40 IS - 6 N2 - UNLABELLED: Are there circadian patterns for time of presentation and clinical status in asthmatic patients admitted to an emergency department for acute exacerbations? DESIGN: Prospective observational study. SETTING: Urban community teaching hospital emergency department. PARTICIPANTS: 279 consecutive patients who presented a total of 310 times with asthma exacerbations between October 19 and December 31, 1993. We grouped patients aged 16 years and above as adults and patients younger than 16 years of age as children. INFORMATION COLLECTED: Time of emergency department presentation, time attack began (for adult patients), peak expiratory flowrate prior to emergency department treatment (for adult patients), need for hospital admission, ventilatory failure during an acute attack, and death during an acute attack. RESULTS: Circadian patterns were demonstrated for time of presentation. For the total study group, the peak time of presentation was 8:00 PM to 11:59 PM (p < 0.05) and the trough time of presentation was 4:00 AM to 7:59 AM (p < 0.01). There were differences in peak time of presentation for patients grouped by age. For adult patients only, the peak time of presentation was 8:00 AM to 11:59 AM (p < 0.01), whereas for children only, the peak time of presentation was 8:00 PM to 11:59 PM (p < 0.001). No statistically significant patterns in time of attack onset, hospital admission rates, or peak flow measurements were observed. CONCLUSIONS: There are circadian patterns for the time at which patients with acute asthmatic exacerbations present to our emergency department. Adult patients have a peak time of presentation between 8:00 AM and 11:59 AM, whereas children have an apparent peak time of presentation between 8:00 PM and 11:59 PM. For all age groups, there is a trough in presentation between 4:00 AM and 7:59 AM. SN - 0020-1324 UR - https://www.unboundmedicine.com/medline/citation/10143508/Circadian_patterns_of_emergency_asthma_presentations:_implications_for_staffing_and_treatment_ L2 - http://www.diseaseinfosearch.org/result/633 DB - PRIME DP - Unbound Medicine ER -