Clinical study of patients with nocturnal asthmatic attacks admitted to an emergency room

: Over the periods of a year, we studied the patients who were admitted to the emergency room at our hospital at night with asthmatic attacks. From July 1991 to June 1992, 10,932 patients were admitted to the internal department of our emergency room, 707 (6.5%) of them because of asthmatic attacks. These 707 consisted of 364 patients (51.5%) with mild attacks, 242 (34.2%) with moderate attacks and 101 (14.3%) with severe attacks according to Mitsui's score. Most patients admitted before 23:00 and after 5:00, but more patients with severe attacks were admitted around midnight. A large part of the patients with moderate or severe attacks had chronic hypoxemia, and more than half of the patients' serum theophylline concentration was under the therapeutic rate. More than half patients were treated within 5 minutes. But within those who were not, 6 patients with mild attacks on admission needed hospitalization later. For prevention of life threatening attack, we should regard it as an important problem to follow up the patients who don't come to the hospital in the daytime in spite of frequent visits to the emergency room at night.