A survey of asthma mortality in patients between ages 35 and 64 in the Greater London hospitals in 1971

Abstract

The authors examined the death certificates from all patients aged 35-64 yr who were recorded as dying from asthma in 1971. Of the 47 death certificates studied, 9 suggested that the primary cause of death was not asthma. From the remaining 38 deaths the authors obtained 36 case records and found that 15 deaths occurred outside hospital and another 2 patients died in hospital having been admitted in a stable state. The remaining 19 case records were examined to find out the circumstances of death in patients with asthma who die in hospital. The authors were unable to exclude the possibility that many of the deaths in hospital were avoidable. Assessment of severity in most patients was incomplete, as judged by a retrospective analysis of case records, and many of the patients would be regarded as having had insufficient treatment. 4 patients did not receive corticosteroids and in a further 3 the dose given was small. No physiological assessment of airflow obstruction was made in over half of the patients. A comparison with 19 survivors of an admission to hospital with asthma did not provide enough information to account for the deaths. The survivors were in hospital for a shorter period of time, were slightly less ill, and were given comparable treatment regimens. Both groups of patients were inadequately assessed, and sedatives were given to approximately 70% of all subjects studied. The deaths in hospital usually occurred suddenly in the early morning in general medical wards.