A nationwide survey in Germany on fatal asthma and near-fatal asthma in children: different entities?
In adults fatal and near-fatal asthma have similar clinical characteristics. Therefore, near-fatal asthma in adults can be used as a model for fatal asthma. A nationwide study on fatal and near-fatal asthma in children <16 yrs was performed in order to assess whether, as in adults, near-fatal asthma can be used as a model for fatal asthma. From 1996 to 1998, all paediatric hospitals and paediatric pulmonologists in Germany were asked to report cases of fatal asthma and near-fatal asthma to a central survey unit (Erhebungseinheit für seltene pädiatrische Erkrankungen in Deutschland (ESPED)) on a monthly basis. All reports were followed by detailed questionnaires. Sixteen fatal and 45 near-fatal asthma cases were analysed. Fatal asthma patients were older than near-fatal asthma patients. Respiratory tract infections were frequently reported only in near-fatal asthma (47 versus 0%). The proportion of cases with rapid-type onset (duration of symptoms < or =1 h) was higher in fatal asthma (53 versus 14%). Long-term regular treatment with short acting beta2-agonists was common in both groups, but the use of concomitant inhaled corticosteroids was significantly lower in fatal asthma cases. A high proportion of poor compliance was observed in both groups. As fatal and near-fatal asthma differ significantly in important clinical aspects, analysis of near-fatal asthma might be of limited value in elucidating the causes of fatal asthma in children.
Schmitz
T
T
Dept of Paediatrics, Heinrich Heine University, Düsseldorf, Germany.
von Kries
R
R
Wjst
M
M
Schuster
A
A
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D017677:Age Distribution; D001249:Asthma / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005858:Germany; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D010349:Patient Compliance; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists