Risk factors for death in patients with severe asthma

Abstract

OBJECTIVE: To identify risk factors for death among patients with severe asthma. METHODS: This was a nested case-control study. Among the patients with severe asthma treated between December of 2002 and December of 2010 at the Central Referral Outpatient Clinic of the Bahia State Asthma Control Program, in the city of Salvador, Brazil, we selected all those who died, as well as selecting other patients with severe asthma to be used as controls (at a ratio of 1:4). Data were collected from the medical charts of the patients, home visit reports, and death certificates. RESULTS: We selected 58 cases of deaths and 232 control cases. Most of the deaths were attributed to respiratory causes and occurred within a health care facility. Advanced age, unemployment, rhinitis, symptoms of gastroesophageal reflux disease, long-standing asthma, and persistent airflow obstruction were common features in both groups. Multivariate analysis showed that male gender, FEV1 pre-bronchodilator < 60% of predicted, and the lack of control of asthma symptoms were significantly and independently associated with mortality in this sample of patients with severe asthma. CONCLUSIONS: In this cohort of outpatients with severe asthma, the deaths occurred predominantly due to respiratory causes and within a health care facility. Lack of asthma control and male gender were risk factors for mortality.

Survival analysis of asthma patients attended to at Chitungwiza Central Hospital in Zimbabwe

“…Higher mortality rates were observed among males compared to females. These findings are comparable to those reported in Brazil [10] and Australia [11]. The reasons why males were are at higher risk of death were unclear but could be related to non-adherence to medication and poor health-seeking behaviour.…”

“…These results echo those reported in Australia and New Zealand [16]. According to Fernandes et al [10], a lack of asthma control is a risk factor for mortality among individuals with severe asthma.…”

“…Our results revealed that most of the patients died at a health care facilities as was observed in Brazil [10]. Such findings are unsurprising since patients with severe symptoms of asthma are more likely to be hospitalized.…”

The association between blood eosinophil count and benralizumab efficacy for patients with severe, uncontrolled asthma: subanalyses of the Phase III SIROCCO and CALIMA studies

“…Thus, a significant unmet medical need remains. Patients with severe, uncontrolled asthma have increased morbidity, reduced healthrelated quality of life and increased health care resource use, and, therefore, need additional therapeutic options [4][5][6][7] .…”

Reslizumab and Eosinophilic Asthma: One Step Closer to Precision Medicine?

“…These patients experience a high disease burden including recurrent exacerbations and hospital admissions (7). Finally, the cost of asthma treatment increases with disease severity (8).…”