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Pitfalls in the Use of Clinical Asthma Scoring
M. Douglas Baker, MD
Am J Dis Child. 1988;142(2):183-185.
Abstract
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• We evaluated the correlation of the Wood-Downes-Lecks clinical asthma score (CAS) with outcome in 210 consecutive known asthmatic children presenting to an urban emergency department for treatment of acute asthma. All children received standard treatment consisting of administration of β-adrenergic agents and theophylline compounds. Clinical asthma scores were assigned before each treatment phase and before disposition from the emergency department. Ten-day follow-up information was collected on each patient by telephone. While no differences in pretreatment CASs were found between outcome groups, disposition CASs were found to be significantly higher in patients eventually admitted to the hospital as opposed to those discharged home. However, CASs were not effective in identifying either those patients who required prolonged hospitalization (>24 hours) or those who sustained ongoing disability following discharge home from the emergency department. These data indicate that the CAS alone is not a reliable Indicator of severity of acute asthma of childhood as judged by subsequent disability.
(AJDC 1988;142:183-185)
Author Affiliations
From the Department of Pediatrics, The University of Pennsylvania, School of Medicine, and the Division of General Pediatrics, Emergency Medicine, The Children's Hospital of Philadelphia.
Footnotes
Accepted for publication Aug 11, 1987.
Presented in part before the 27th Annual Meeting of the Ambulatory Pediatric Association, Anaheim, Calif, April 30, 1987.
Reprint requests to Emergency Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Baker).
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