HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (32) Citing Articles via Google Scholar Google Scholar Articles by Mitchell, I. Articles by Hessel, P. A. Search for Related Content PubMed PubMed Citation Articles by Mitchell, I. Articles by Hessel, P. A.

Near-Fatal Asthma^*

A Population-Based Study of Risk Factors

^* From the Child Health Research Unit (Drs. Mitchell and Tough, and Ms. Semple) and the Respiratory Research Group (Dr. Green), University of Calgary, Calgary, AB; and the Department of Public Health Sciences (Dr. Hessel), University of Alberta, Edmonton, AB, Canada.

Correspondence to: I. Mitchell, MD, FCCP, 1820 Richmond Rd SW, Calgary, AB, Canada, T2T 5C7; e-mail: ian.mitchell{at}calgaryhealthregion.ca

Background: The study of near-fatal asthma (NFA) may provide a means to further our understanding of fatal asthma. Studies of NFA often are derived from a single ICU rather than from a defined population. We therefore aimed to identify factors distinguishing NFA patients (cases) from those persons treated in an emergency department (ED) [ED control subjects] and in the community (community control subjects [CCs]).

Methods: This was a population-based case-control study conducted over 20 months of 45 NFA patients (age range, 5 to 50 years), 197 ED control subjects treated in an ED, and 303 CCs, all of whom were residents of Alberta.

Results: The age distribution was similar between NFA patients and control subjects, with the majority being < 22 years of age (NFA patients, 68.9%; ED control subjects, 71.3%; CCs, 60.7%). Those patients with NFA were significantly more likely to have received a diagnosis before 5 years of age (66.6%), compared to ED control subjects (39.6%) and CCs (28.7%). The NFA group was significantly more likely to report moderate-to-severe disease and more frequent symptoms than the other groups. Therapy with bronchodilators was used most frequently by the NFA group compared to the ED control subjects and CCs (p < 0.001), as was therapy with inhaled steroids (p < 0.001) and oral steroids (p < 0.001). NFA patients had higher scores for vulnerability and were most likely to admit to stress as an asthma trigger. All groups had high exposure to cigarette smoke and pets.

Conclusion: NFA patients have many modifiable risk factors and many similarities to ED control subjects and CCs with asthma. General measures to improve asthma control and awareness of risks are required in all groups.

Key Words: asthma • near-fatal asthma • population based • risk factors

This article has been cited by other articles:

				N.C. Thomson, R. Chaudhuri, and E. Livingston Asthma and cigarette smoking Eur. Respir. J., November 1, 2004; 24(5): 822 - 833. [Abstract] [Full Text] [PDF]

				A. F. Gelb, A. Schein, E. Nussbaum, C. M. Shinar, Y. Aelony, H. Aharonian, and N. Zamel Risk Factors for Near-Fatal Asthma Chest, October 1, 2004; 126(4): 1138 - 1146. [Abstract] [Full Text] [PDF]

				E. Barreiro, J. Gea, C. Sanjuas, R. Marcos, J. Broquetas, and J. Milic-Emili Dyspnoea at rest and at the end of different exercises in patients with near-fatal asthma Eur. Respir. J., August 1, 2004; 24(2): 219 - 225. [Abstract] [Full Text] [PDF]