Multinational cohort study of mortality in patients with asthma and severe asthma.

Abstract:

BACKGROUND:Data on the risk of death following an asthma exacerbation are scarce. With this multinational cohort study, we assessed all-cause mortality rates, mortality rates following an exacerbation, and patient characteristics associated with all-cause mortality in asthma. METHODS:Asthma patients aged ≥18 years and with ≥1 year of follow-up were identified in 5 European electronic databases from the Netherlands, Italy, UK, Denmark and Spain during the study period January 1, 2008-December 31, 2013. Patients with asthma-COPD overlap were excluded. Severe asthma was defined as use of high dose ICS + use of a second controller. Severe asthma exacerbations were defined as emergency department visits, hospitalizations or systemic corticosteroid use, all for reason of asthma. RESULTS:The cohort consisted of 586,436 asthma patients of which 42,611 patients (7.3%) had severe asthma. The age and sex standardized all-cause mortality rates ranged between databases from 5.2 to 9.5/1000 person-years (PY) in asthma, and between 11.3 and 14.8/1000 PY in severe asthma. The all-cause mortality rate in the first week following a severe asthma exacerbation ranged between 14.1 and 59.9/1000 PY. Mortality rates remained high in the first month following a severe asthma exacerbation and decreased thereafter. Higher age, male gender, comorbidity, smoking, and previous severe asthma exacerbations were associated with mortality. CONCLUSION:All-cause mortality following a severe exacerbation is high, especially in the first month following the event. Smoking cessation, comorbidity-management and asthma-treatment focusing on the prevention of exacerbations might reduce associated mortality.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Engelkes M,de Ridder MA,Svensson E,Berencsi K,Prieto-Alhambra D,Lapi F,Giaquinto C,Picelli G,Boudiaf N,Albers FC,Cockle SM,Bradford ES,Suruki RY,Brusselle GG,Rijnbeek PR,Sturkenboom MC,Verhamme KM

doi

10.1016/j.rmed.2020.105919

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

105919

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(20)30059-7

journal_volume

165

pub_type

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