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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

Sudden death in young persons with uncontrolled asthma - a nationwide cohort study in Denmark

Zeitschrift:
BMC Pulmonary Medicine > Ausgabe 1/2015
Autoren:
Anders Juul Gullach, Bjarke Risgaard, Thomas Hadberg Lynge, Reza Jabbari, Charlotte Glinge, Stig Haunsø, Vibeke Backer, Bo Gregers Winkel, Jacob Tfelt-Hansen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12890-015-0033-z) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

AJG: Drafting of manuscript, statistics, data collection, data analysis. BR: Data collection, drafting of manuscript. THL: Data collection, critical revision of manuscript and data analysis. RJ: Critical revision of manuscript and data analysis. CG: Data collection, critical revision of manuscript and data analysis. SH: Fundraising and critical revision of manuscript. VB: Critical revision of manuscript. BGW: Critical revision of manuscript and study design. JT: Critical revision of manuscript, study design and data analysis. All authors read and approved the final manuscript.

Abstract

Background

Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled asthma as a previous hospital admittance because of asthma (of any severity) or when asthma was considered to have influenced the death according to the death certificate. The purpose of this study is to increase the medical focus on young persons with uncontrolled asthma and thereby hopefully aid in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma.

Methods

Through the review of death certificates, we found 625 sudden unexpected death cases in individuals aged 1–35 years in Denmark from 2000 to 2006. Of those, 49 persons with uncontrolled asthma were identified.
Previous contacts with the healthcare system were identified, and available records from general practitioners were retrieved.

Results

We identified 49 individuals who suffered from uncontrolled asthma. This corresponds to an incidence rate of 0.32 per 100,000 person-years. The cause of death in 31 cases (63%) was sudden cardiac death, and in 13 cases (27%), it was a fatal asthma attack.
Symptoms (chest pain, dyspnea, seizures, general malaise, syncope, and palpitations) prior to death were reported in 41 (84%) of the cases. In 34 (69%) of the cases, antecedent symptoms (symptoms >24 hours before death) were present, and 28 (57%) patients had prodromal symptoms (symptoms <24 hours before death). The most common antecedent symptoms were dyspnea and chest pain, whereas the most common prodromal symptoms were dyspnea, general malaise, and/or fatigue. Twenty-eight patients (57%) sought medical advice from a general practitioner and/or emergency department due to these symptoms.

Conclusion

The cause of death was predominantly sudden cardiac death followed by fatal asthma attack. We found that 41 (84%) of patients suffered from symptoms prior to death and that 28 (57%) sought medical advice from the emergency department and/or general practitioners.
Zusatzmaterial
Additional file 1: Supplementary data on infants ≤ 5 years.Table S1. – Clinical characteristics and circumstances surrounding the death for infants ≤ 5 years of age. Table S2. Symptoms prior to death in infants ≤ 5 years of age.
12890_2015_33_MOESM1_ESM.docx
Literatur
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