Trends in asthma hospital admissions and mortality in Kuwait, 2000–2014: a national retrospective observational study

Abstract

ObjectivesTo examine trends in asthma hospitalisation and mortality rates from 2000 to 2014 in Kuwait according to sex, age and nationality.MethodsFor this nationwide, retrospective observational study, data from hospital discharge records and death certificates listing asthma as the primary reason for hospitalisation or mortality were obtained from the National Center for Health Information database using International Classification of Diseases, Tenth Revision codes J45 and J46. Trends in sex-adjusted, age-adjusted and nationality-adjusted hospitalisation and mortality rates were examined. Poisson regression models were applied to test for linear trends overtime and estimate adjusted rate ratios and 95% CI.ResultsDuring the 15-year study period, a total of 43 652 hospitalisations and 484 deaths due to asthma exacerbations were identified. The average annual adjusted rates of asthma hospitalisation and mortality were estimated to be 134.9 (95% CI 131.8 to 138.1) and 2.1 (95% CI 1.8 to 2.4) per 100 000 population, respectively. Hospitalisation rates decreased by 49.5% in the total population (from 180.8 to 91.3 admissions per 100 000 population between 2000 and 2014, ptrend <0.001) and by 57.9% in the age group of 5–44 years (from 77.3 to 32.5 admissions per 100 000 population, ptrend <0.001). Mortality rates decreased from 4.1 to 0.9 deaths per 100 000 population between 2000 and 2014 in the total population (77.6% decrease, ptrend <0.001) and from 0.6 to 0.2 deaths per 100 000 population among those aged 5–44 years (61.9% reduction, ptrend=0.005). Kuwaiti compared with non-Kuwaiti subjects had higher risk of asthma hospitalisation and mortality. Among children aged ≤19 years, the risk of hospitalisation was higher in boys compared with girls; however, among adults, women experienced more hospitalisations than men.ConclusionsAsthma hospitalisation and mortality rates have substantially decreased between 2000 and 2014 in Kuwait, with persisting differences between genders, age groups and citizens versus non-citizens. The observed decreasing trends in Kuwait are in agreement with global trends.

Asthma Mortality and Hospitalizations in Mexico from 2010 to 2018: Retrospective Epidemiologic Profile

“…One of the main results of the present study is that for patients 0–15 years old, the hospitalization rate for asthma in Mexico (2010–2018) was higher in males, but it was higher in females for the other age groups. These results are similar to studies carried out in Kuwait by Ziyab et al and Santos et al carried out in Portugal [ 29 , 35 ]. However, in a study carried out in Mexico City by Del-Rio-Navarro and colleagues, the difference in the prevalence of the disease by gender is not significant in children and adolescents in the general population.…”

“…Among hospitalized patients, epidemiological characteristics are related to clinical courses and outcomes among patients. Consistent with previous studies in the USA, Brazil, France, Kuwait, Costa Rica, and Galicia, we found a reduced asthma hospitalization rate for all age groups throughout the studied period [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Vargas et al reported a similar decreased health services trend of asthma over the years translating, into a decrease in hospitalizations [ 30 ].…”

A prospective study of switching asthma patients from a Fixed-Dose Combination (FDC) Inhaled Corticosteroid [ICS]/Long-Acting Beta Agonist [LABA] therapy delivered by Dry Powder Inhaler (DPI) to ICS/LABA delivered by pressurised Metered Dose Inhaler (pMDI)

“…The Global Burden of Diseases study estimated that, in 2017, more than 272 million people were living with asthma and it accounted for over 10.6 million years lived with disability [2]. Incidence and prevalence rates are highest in children, but asthma-related morbidity, healthcare use and mortality are higher in adults [4,5]. Although in comparison with other chronic diseases mortality related to asthma is relatively low, in 2016 poorly controlled asthma was responsible for approximately 400 000 deaths worldwide [3].…”

“…Studies estimate that approximately 10-12% of adults in Kuwait are asthmatic, compared to only 4-8% in Turkey, Egypt, UAE and Saudi Arabia [6]. [[,7] Despite the increasing prevalence of asthma worldwide, improvement in management strategies and treatments and access to high quality healthcare services in Kuwait have led to substantial reductions in asthma-related hospital admission and mortality rates in this country [4,5]. Nevertheless, chronic asthma in this country is associated with significant comorbidity and impaired quality of life, and management and treatments are associated with considerable financial burden [5,6].…”

Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy

“…In Iraq, about 200,000 patients per year with asthma are either hospitalised or treated in an emergency room. Prevalence of asthma in the adjacent countries to Iraq includes 5.6 % in Saudi Arabia and 8.5 % in Kuwait [4], [5].…”