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

Abstract

Objectives To examine trends in asthma hospitalisation and mortality rates from 2000 to 2014 in Kuwait according to sex, age and nationality. Methods For 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. Results During 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, p trend <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, p trend <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, p trend <0.001) and from 0.6 to 0.2 deaths per 100 000 population among those aged 5-44 years (61.9% reduction, p trend =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. Conclusions Asthma 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.