Mulla et al (BMJ open 2013) sought to determine if chronic pulmonary diseases such as asthma, chronic obstructive pulmonary disease (COPD), and cystic fibrosis adversely impacted outcomes in hospitalized patients with various allergic conditions including anaphylaxis. The authors used data collected from a statewide hospital discharge database, of which 2410 individuals had anaphylaxis. Asthmatics were found to have more than twice the odds of receiving mechanical ventilation and sufferers of chronic bronchitis and COPD had a prolonged hospitalization stay. The unique analysis of a large database allowed the authors to determine that chronic pulmonary diseases increased the risk of adverse outcomes among hospitalized patients with anaphylaxis.
The authors did not have access to the complete medical records of the patients, how could this have affected outcomes?
Could there be anaphylaxis coding inconsistencies in hospital databases especially in patients with pulmonary disease?