Thirty deaths from asthma.

Abstract

Surveys in London and Newcastle3 4 suggest that childhood asthma is being underdiagnosed and undertreated. Despite many leading articles and reviews 9 and the increased admission rates of asthmatic children to hospital, there is little evidence of a decline in paediatric mortality. The present survey was carried out to ascertain the circumstances of the deaths and to decide if these were avoidable. Methods

A childhood asthma death in a clinical trial: potential indicators of risk

“…This has offered the opportunity to detect the features which distinguished her from the others and which might be indicators of risk of death. Usually asthma deaths are reported to occur in the early hours of the morning [5,7,13,14,21,22]. However, deaths have also been reported in the afternoon and evenings as in our patient [13,15].…”

“…However, the smaller surveys conducted in the paediatric age range have tended to reveal similar results. The range of factors associated with increased risk of death include poor socioeconomic circumstances [15], delay in diagnosis and under-treatment of disease, both long-term [8] and in the final acute event [7]. Such factors as poor perception of airflow limitation and inadequate use of oral corticosteroid are also highlighted [3,7,13,14].…”

“…The range of factors associated with increased risk of death include poor socioeconomic circumstances [15], delay in diagnosis and under-treatment of disease, both long-term [8] and in the final acute event [7]. Such factors as poor perception of airflow limitation and inadequate use of oral corticosteroid are also highlighted [3,7,13,14]. However, no studies have been able to satisfactorily compare and contrast the factors in the patients who have died with those of individuals with severe asthma who have not died.…”

“…Thus, one survey identified the deaths as occurring in chronic asthma sufferers, usually at night after a lengthy period of deterioration with inadequate management and deficiencies in corticosteroid treatment. A greater proportion of girls died than would have been predicted from the proportion attending hospital [7]. A survey of asthma deaths in the age group 1-16 yrs in the Northern Health Region of England identified 35 cases over a 15 yr period.…”

Deaths from asthma in New Zealand.

“…In Avon county, England, 26 of 28 possible cases were detected by a search of death certificates. 4 The present study provides a wider range of deaths than earlier series based on hospital treated patients,98 and more complete information on circumstances surrounding death, including treatment, than was available for cases dying in (37%) or out (63%) of hospital in Avon county. 4 The dominance of Maoris in the under 10 age group and the fivefold increase in mortality from asthma among Maori children is a cause for particular concern.…”