{
  "abstract": "Introduction Asthma exacerbations result in approximately 43 hospitalizations per 100,000 in Ireland. 1 They are associated with considerable morbidity, mortality, and healthcare costs. Despite improved specialist services, better ICS/LABA therapies and targeted monoclonal antibodies, it’s unknown if ICU admission for asthma exacerbations have decreased.Aim We aimed to assess any change in trends in ICU exacerbations for asthma in our hospital from 2003–2024, and investigate potential reasons for lack-of-change. We hypothesised that non-engagement in services is an important reason for ICU admission.Methods A retrospective analysis of ICU admissions for asthma in our institution from 2003 onwards was undertaken. Demographics, respiratory supports, presence of T2 inflammation, length of ICU stay (LOS), mortality and lung function were analysed.Results 63 patients had 99 ICU admissions for asthma over this period. Median LOS was 2 days (IQR 1.6–4 days). There was a female predominance (n= 35, 55%). Median age was 47.5 years. T2 inflammation was prevalent, with 85% having evidence of peripheral blood eosinophil (PBE) ≥0.3, with median maximum recorded PBE of 0.51 (IQR 0.34–0.89). There were three asthma related deaths. Figure 1 demonstrates annual ICU admissions for asthma.PFT data were available for only 39 patients. Of those with a single ICU admission (n=23), five met ERS criteria for asthma.2 High rates of non-attendance to scheduled outpatients was notable, with a median of 14 missed-attendances per patient (range 0–139).Abstract P69 Figure 1Demonstrates an upsurge in ICU admissions during the 2019–2020 periodConclusion Despite improvements in asthma therapies, we have not seen a reduction in ICU presentations the past 20 years. While trends from 2020–2022 may reflect the Covid-19 pandemic, lack of engagement in healthcare when well, evidenced by high DNA/cancellation rates to outpatient appointments, remains a prominent issue in this population, and may contribute to these patients’ severe exacerbations. Ways to engage this cohort are imperative to improve outcomes.References Chapter-6-Asthma.pdf [Internet]. [cited 2025 Jun 19]. Available from: https://irishthoracicsociety.com/wp-content/uploads/2019/04/Chapter-6-Asthma.pdfLouis R, Satia I, Ojanguren I, Schleich F, Bonini M, Tonia T, et al. European Respiratory Society guidelines for the diagnosis of asthma in adults. Eur Respir J. 2022;60(3):2101585.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland"
      ],
      "name": "C Ottewill"
    },
    {
      "affiliations": [
        "Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "S Walsh"
    },
    {
      "affiliations": [
        "Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland"
      ],
      "name": "C Gill"
    },
    {
      "affiliations": [
        "Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "J Mullvihill"
    },
    {
      "affiliations": [
        "Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "R Dwyer"
    },
    {
      "affiliations": [
        "Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland"
      ],
      "name": "RA Leary"
    },
    {
      "affiliations": [
        "Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland"
      ],
      "name": "RW Costello"
    }
  ],
  "title": "P69 Intensive care admissions for asthma are characterized by frequent non-attendance to outpatient appointments",
  "uid": "92a7a955-b80b-593d-ad49-2f387ebdd2f2"
}