Asthma Mortality in a Metropolitan County Hospital, a 38-Year Study

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Abstract
A 38-year (1949–1986) retrospective chart review of 535 decedent asthmatic patients was undertaken to determine trends in asthma-related deaths. Records of 187 decedents with clinical and autopsy evidence were analyzed. An overall decrease in asthma-related deaths over the four interval periods of the study was noted. Thirty-five percent of the patients died within 24 hours, and 85% died within 7 days of admission. Seventy-five percent of decedents were > 40 years of age. Fifty-two percent of the patients were white, 34% black, and 13% Hispanic. Mortality was higher in younger (40 years) whites. The number of deaths was inversely proportional to the number of patients managed in the pulmonary/ICU setting. Longer duration (>10 years) of asthma was associated with a higher (60%) mortality. Mucus plugging occurred in 74% of patients. Previous hospitalization (93%), previous intubations, and inadequate assessment (peak expiratory flow rates, pulsus paradoxus) also were associated with higher mortality.

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