Background: Asthma exacerbation may require a visit to the emergency room as well as hospitalization and can\noccasionally be fatal. However, there is limited information about the prognostic factors for asthma exacerbation\nrequiring hospitalization, and no methods are available to predict an inpatientââ?¬â?¢s prognosis. We investigated the\nclinical features and factors affecting in-hospital mortality of patients with asthma exacerbation and generated a\nnomogram to predict in-hospital death using a national inpatient database in Japan.\nMethods: We retrospectively collected data concerning hospitalization of adult patients with asthma exacerbation\nbetween July 2010 and March 2013 using the Japanese Diagnosis Procedure Combination database. We recorded\npatient characteristics and performed Cox proportional hazards regression analysis to assess the factors associated\nwith all-cause in-hospital mortality. Then, we constructed a nomogram to predict in-hospital death.\nResults: A total of 19,684 patients with asthma exacerbation were identified; their mean age was 58.8 years\n(standard deviation, 19.7 years) and median length of hospital stay was 8 days (interquartile range, 5ââ?¬â??12 days).\nAmong study patients, 118 died in the hospital (0.6%). Factors associated with higher in-hospital mortality\nincluded older age, male sex, reduced level of consciousness, pneumonia, and heart failure. A nomogram was\ngenerated to predict the in-hospital death based on the existence of seven variables at admission. The nomogram\nallowed us to estimate the probability of in-hospital death, and the calibration plot based on these results was well\nfitted to predict the in-hospital prognosis. Conclusion: Our nomogram allows physicians to predict individual risk of in-hospital death in patients with asthma\nexacerbation
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