Long-term Mortality Among Adults with Asthma
September 1, 2013 less than 1 minute read
In the united states, approximately 5000 persons die each year from asthma. Counterintuitively, deaths in asthma are equally distributed among patients identified as mild, moderate, and severe. Studies of patients with near-fatal asthma have found a decreased sensitivity to hypoxia, hypercapnea, and resistance loading, suggesting that persons destined to succumb to asthma may not fully appreciate the severity of their symptoms, placing them at risk for unrecognized deterioration.
The long-term picture of causes of death in asthmatic adults was the subject of this report by Ali et al. The authors drew on a population of asthmatics enrolled from 1974-1990 in Denmark at their first visit for asthma to the Copenhagen Frederiksbergy Hospital Allergy and Chest Clinic, having been referred there by their general practitioners in the community. More than 75% of the enrollees were younger than 50 years of age at the time of enrollment.
Compared with age- and sex-matched control subjects, all-cause mortality in asthmatic subjects was essentially doubled over 25 years of follow-up. The excess risk for death was primarily due to obstructive airways disease, but was unrelated to smoking status (hence deaths were predominantly not related to chronic obstructive pulmonary disease). Degree of peripheral blood eosinophilia correlated with mortality, intimating that unmitigated atopy in asthmatics may contribute to adverse outcomes.
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