Number Of Asthma Deaths Research Articles

The prevalence and years lived with disability of asthma in children under 5 years old in Sichuan Southwest China, 1990-2019: A cross-sectional study.

ObjectivesTo analyze the prevalence and Years Lived with Disability of Asthma in children under 5 years old and the time trends in Sichuan Southwest China from 1990–2019.MethodsBased on the results of the Global Burden of Disease Study 2019 (GBD2019), we present the time trend, sex specific prevalence, Years Lived with Disability (YLDs) and deaths due to asthma under 5 years old in Sichuan and compared them with national indicators in the same period.ResultsThe number of children under 5 years old with asthma decreased overall from 1990 to 2007 and increased overall from 2008 to 2019. The time trend of prevalence rate was similar. In 2019, over 111 thousands children under 5 years old suffered from asthma, the prevalence rate was 2,584 per 100 thousand, YLDs was 4.5 thousands, and YLDs rate was 105 per 100 thousand in Sichuan. Compared with 1990, the number of patients decreased by 48.6%, the prevalence increased by 9.4%, the YLDs decreased by 48.9%, and the YLDs rate increased by 9.7% in 2019. The increase in the prevalence and YLDs rate of asthma children in Sichuan was higher than the national overall, but the number of asthma deaths and deaths rate in Sichuan and the whole nation all decreased.ConclusionsThe results in Sichuan Southwest China show the prevalence and YLDs of asthma children under 5 years old increased over the past 30 years, and were higher than the overall increase in China. Male children are the key population of increasing asthma disease burden and deserves more attention. More targeted prevention and control measures are still needed to reduce the incidence of asthma.

Asthma mortality among children and adolescents in China, 2008-2018.

Asthma mortality among children and adolescents at the national level in China was unreported. The aim of this study was to analyze the mortality of asthma among children and adolescents in China using a nationally representative database. This was a descriptive study using data from the Disease Surveillance Points (DSPs) system. All asthma-related deaths among children and adolescents aged 0-19years occurring in DSPs across China from 2008 to 2018 were included. Multilevel Poisson regression models were used to compute the total, age-, gender-, region- and residence-specific asthma mortality rates and to investigate the significance of trends and factors associated with asthma mortality. Data from the National Bureau of Statistics were used to estimate the national asthma deaths. Total asthma mortality rate among Chinese children and adolescents fluctuated between 0.020 (0.009, 0.045) and 0.059 (0.025, 0.137) per 100,000 and showed an overall downward trend (RR, 0.909; 95% CI 0.854-0.968) during the study period (2008-2018). Asthma mortality rate was higher in the western China (RR 2.356, 95% CI 1.513, 3.669) and varied over a ninefold range among DSPs in China. The estimated number of deaths decreased by 51.38% from 2008 (n = 148; 95% CI 58,379) to 2018 (n = 71; 95% CI 34,109). Asthma mortality rate among children and adolescents in China was at a low level compared to rates worldwide and decreased significantly from 2008 to 2018. Compared with most countries in the world, the number of asthma deaths was higher in China.

The current state and provisions for elderly patients with asthma.

Demographic statistics of Japan indicate that it is moving toward a super‐aging society and, accordingly, the ratio of elderly patients with asthma is also increasing. An important point in diagnosing elderly patients with asthma is that the onset of asthma in old age, along with a history of smoking, differentiation, and complications of chronic obstructive pulmonary disease must be considered. Primary care physicians must understand the characteristics of elderly patients when treating them. When conducting inhalation therapy in any asthmatic patient, especially elderly asthmatic patients, it is important to teach the patients proper technique and sustain medication adherence. We believe this effort will lead to an improvement in controlling asthma as well as a decrease in the number of asthma deaths.

Adherence with Long-Term Asthma Management in Patients Who Experienced Hospitalized Asthma Exacerbation

In Japan, the number of asthma deaths has been gradually decreasing. However, in the management of asthma, there are still some problems originating from patient-related factors and iatrogenic factors, both of which should be further analyzed. We investigated clinical and background characteristics of 164 patients with asthma who were admitted to our hospital with acute exacerbations, by reviewing their clinical records. Fifty-two patients had received long-term management (LTM) based on the guidelines (the LTM group), while 112 had not (the non-LTM group). In patients whose asthma severity had been intermittent (step 1), the proportion of severe and near fatal exacerbations was significantly higher in the non-LTM group than in the LTM group. However, even in the LTM-group, 23% of mild persistent (step 2) and 38% of moderately and severely persistent (step 3 & 4) patients had severe or near fatal exacerbations. In these patients, the peak expiratory flow rate significantly improved after discharge, and poor adherence was also significantly higher in the non-LTM group than in the LTM group. A multivariate analysis revealed that the factors associated with poor adherence were: 1) no history of previous admission due to asthma exacerbation; 2) the patient was male; and 3) the patient was young (<60 years). In the LTM group, re-evaluation of the actual severity of asthma and prompt treatment corresponding to the severity of disease should still be encouraged. In the non-LTM group, establishing countermeasures against factors causing poor adherence would be the next step in ensuring strong adherence with LTM.

Ecologic analysis of asthma-related events and dispensing of inhaled corticosteroid- and salmeterol-containing products

An association between salmeterol use and serious asthma episodes or asthma-related mortality has been noted in 2 clinical trials; however, a causal relationship has not been established. To date, observational studies have not replicated this finding. To examine the relationship between number of prescriptions dispensed of salmeterol-containing products and inhaled corticosteroid (ICS)-containing products and the rates of asthma-related hospitalizations and mortality in the United States. In this ecologic study, annual age-adjusted rates of asthma-related hospitalization and asthma-related mortality from US population-based sources were graphed alongside annual number of prescriptions dispensed of salmeterol- and ICS-containing products by year from 1991 to 2004. We computed the Spearman rank correlations between number of prescriptions dispensed and serious events (asthma-related hospitalization rate, number of hospitalizations, asthma-related mortality rate, and number of asthma deaths). During more than 14 years, while number of prescriptions dispensed of salmeterol-containing and ICS-containing products increased, age-adjusted asthma-related mortality rates declined and asthma-related hospitalization rates remained relatively stable. The number of asthma-related deaths has decreased steadily since the mid-1990s. This study provides population-level evidence that asthma-related death rates declined and asthma-related hospitalization rates remained relatively constant for more than 14 years during a period of improvements in asthma management per treatment guidelines, including increased use of maintenance medications, such as ICSs and salmeterol.

Seasonal variation in asthma hospitalizations and death rates in New Zealand

The aim of this study was to determine if there is a seasonal pattern to asthma hospitalizations and mortality in New Zealand. Data for an 18-20 year period were obtained for the whole of New Zealand regarding the number of asthma deaths and hospital discharges in each month, as well as annual population totals (1978-1995 for asthma hospitalizations, 1976-1995 for asthma deaths). Monthly mortality and hospital discharge rates were calculated for the age groups 5-14, 15-44, and those aged 45 years and older. Variation about the mean monthly rates was plotted along a linear timescale to observe the seasonal trend. In the oldest age group (45+), asthma mortality and hospitalization rates peaked in the winter months (July/August). Among the younger age groups, however, mortality and hospitalizations showed different seasonal patterns; peak hospitalization occurred in the early winter months, with peak mortality in the early summer months. Seasonal variations in the asthma hospitalization and death rates in New Zealand are similar to those from the Northern Hemisphere. The peak mortality in summer for the younger age groups is paralleled by a reduction in hospitalizations in this period, indicating that the increase in mortality may be due to problems of access to medical care.

Asthma outcome measures.

Annually, asthma accounts for 10.4 million physician visits, 468,000 hospitalizations, 1.8 million emergency room visits, and 10 million missed school days. According to the Centers for Disease Control and Prevention, the number of asthma deaths has increased progressively since 1978 form 1,800 to 5,400 per year. It is an expensive disease, accounting for about 1% of all health expenditure in the United States in 1990. Asthma has a significant impact on the patient and the community at large and the assessment of the clinical, physiologic, humanistic and economic outcomes will be measured.

Improving outcomes in elderly patients with asthma.

Although often regarded as a disease of childhood, asthma is common in elderly people. Although recent figures show a decline over the past few years in the number of asthma deaths in children and younger adults, the same is not true of older adults, in whom most asthma deaths occur. Differences between asthma in young and old patients are seen not only in response to treatment. The nonspecific presentation of asthma in elderly adults means that the diagnosis of asthma is difficult to make. In addition, research suggests that physicians are reluctant to use spirometry and measurement of reversibility when investigating respiratory symptoms in old people. This leads to a tendency to label breathless or wheezy elderly patients as having chronic obstructive pulmonary disease (COPD) rather than asthma. In turn, patients with a diagnosis of COPD are less likely to be treated with bronchodilators and corticosteroids. Treatment guidelines for the management of asthma in children and younger adults may need to be adapted when applied to older patients. Reduced perception of bronchoconstriction may lead to underuse of bronchodilators prescribed 'as required'. The bronchodilator response to beta2-agonists is attenuated as part of the normal aging process, and other groups of bronchodilator medications should be considered. Inhaler technique can be a particular problem in elderly patients with asthma, requiring careful choice of inhaler device. However, the frequent presence of multiple pathology and multiple medication in this age group enhances the risk of adverse effects from oral preparations, and so the inhaled route should be preferred wherever possible. Underestimation of the severity of an acute exacerbation of asthma by both patient and doctor has been suggested as a contributory factor to poor outcome in older people. Since the cardiovascular responses to hypoxia and bronchoconstriction tend to diminish with increasing age, objective measures of asthma severity (peak flow monitoring and blood gas estimation) are essential in this age group.

Characteristics of Asthma Mortality and Morbidity in African-Americans

The percent rise in the number of asthma deaths was analyzed using data from the National Center of Health Statistics and compared for African-Americans and Caucasians. The rate of increase for African-Americans in the period 1979-1983 was nearly twice that of Caucasians, and the difference among genders for Caucasians was significantly higher for females. In Baltimore a high percentage (29%) of adult asthma patients (86.8% African-American) seen in an emergency room (ER) and living in the inner city had frequent visits (6 or more annually) to the ER. One-third of the patients used the ER exclusively for asthma management, and 39% delayed for at least 48 hr after onset of symptoms before seeking medical assistance. One-fourth had daily symptoms, and 11% of those regularly employed had missed 10 or more days annually because of asthma. Among the high ER users, 39% required more than one annual hospitalization for management of acute exacerbation of asthma symptoms. Risk factors for mortality and morbidity among inner-city and minority populations as well as potential areas of intervention are discussed.

Investigation of a cluster of deaths of adolescents from asthma: Evidence implicating inadequate treatment and poor patient adherence with medications

We investigated a cluster of five deaths of adolescents from asthma in St. Louis during a 3-month period in 1987. Although the cluster represented a statistically significant increase in the number of asthma deaths in this age group over that observed in previous years, no common exposure to environmental, infectious, or therapeutic agents could be identified. The patterns of hospital admissions for asthma and emergency room visits at the two pediatric hospitals in the community did not suggest an increase in the frequency or severity of asthma during this time. Despite the lack of evidence for common exposure, the decedents shared many personal and medical characteristics. All decedents were black patients and were of lower socioeconomic status. All were adolescents and were responsible for regulating their own medication schedules. Lack of appreciation of the severity of their asthma by medical personnel and the patients' families was evident. For example, two patients with severe asthma had not been prescribed inhaled corticosteroids. In addition, the four decedents tested had markedly subtherapeutic or zero serum theophylline levels measured at the time of the fatal episode, even though appropriate amounts of theophylline had been prescribed. Their theophylline levels were substantially lower than levels in patients of the same age observed at the emergency room or hospitalized for asthma during the same time period. Continued efforts to educate adolescent patients, their families, and medical care providers about the treatment of asthma are warranted.

Recent Trends in Asthma Mortality, Morbidity, and Management in New Zealand

Trends in mortality and hospital admission rates, prevalence, and drug sales, relating to asthma in New Zealand since 1960 were examined. Two epidemics of asthma death among people in the age range of 15-64 years occurred during this period with peak mortality rates more than four times pre-epidemic rates. Death from asthma was nevertheless rare compared with hospital admissions which have increased 20-fold in children and three- to fivefold in adults between 1960 and 1985. Asthma drug sales have also risen dramatically, particularly in the late 1970s when it is likely that a major change in the drug management of asthma occurred. Changes in asthma prevalence and severity may account in part for the increasing hospital admissions rates. However, the lack of any clear relationship between hospital admissions and death rates and the abrupt time course of the mortality epidemics suggest that changes in the management rather than in the disease itself may be responsible for the increased number of asthma deaths.