The second group at higher risk was women who have asthma attacks triggered by their menstrual cycle, researchers report.
"If they are aspirin-sensitive they have a higher risk for going into the hospital intensive care unit, says Sally Wenzel, MD, professor of medicine at the National Jewish Hospital Medical Research Center in Denver. Many of these patients end up on a breathing machine several times, she says.
Aspirin was at the top of the list of risk factors that could place an asthma patient in the intensive care unit. Patients who had aspirin-sensitive asthma attacks were 3.6 times as likely to end up in intensive care with breathing assistance.
Wenzel revealed the findings at the annual meeting of the American Thoracic Society.
Young Patients Should Avoid Aspirin, Ibuprofen
In light of the study findings, patients who are diagnosed with asthma before age 12, a factor already placing them at higher risk, should not take aspirin or similar products like ibuprofen or naproxen, Wenzel says. "Their option: Tylenol, [because] there is a higher likelihood that they will be aspirin-sensitive," she tells WebMD. Johnson & Johnson, Tylenol's maker, is a WebMD sponsor.
The Denver researchers studied 382 patients with asthma to determine which factors placed them at higher risk for a trip to the emergency room and intensive care.
"This study identifies patients who are at particular risk for a severe asthma attack requiring intensive care," says Herbert Wiedemann, chairman of the department of pulmonary, allergy, and critical care medicine at The Cleveland Clinic. "Now physicians will able to recognize patients at high-risk and help prevent attacks."
Newest Risk Factor: Menstrual Cycle
The newest risk factor shown in this study is asthma related to women's menstrual cycles, Wiedemann says. "Physicians may have to use preventive medicine in these women just before and during their cycle."
Asthma attack risk was equal in risk to aspirin. Women who had asthma attacks before or at the start of their menstrual period had three times the risk of being admitted to the intensive care unit.
Researchers also found that blacks were twice as likely to end up in the emergency room or hospital as other asthma patients. Also, asthma patients who had been previously hospitalized were twice as likely to go through the emergency room and be hospitalized again.
The highest associations were aspirin and premenstrual symptoms, Wenzel says. "Strangely enough, these two associations tended to interact with each other. Both were associated with near-fatal events."
It may be that some patients have certain characteristics that place them more at risk and the current approach to therapy may not be appropriate for them, she says.