Contribution of aspirin-intolerant asthma to near fatal asthma based on a questionnaire survey in Niigata Prefecture, Japan.
OBJECTIVE
Prevention of deaths due to asthma is one of the most important issues in asthma management. However, there are few epidemiological studies of asthma deaths in Japan.


METHODS
Over an 8-week period in Niigata Prefecture, Japan, a questionnaire on asthma control and emergency episodes was administered to adult asthmatic patients. A questionnaire was also given to the patients' physicians to obtain further clinical information. Patients who became unconscious during episodes of asthma, or who required intubation and ventilation, were allocated to a near-fatal asthma group (NFA). Patients who did not fulfill these criteria were allocated to the non-NFA group. The NFA group was divided into two subgroups, based on the date of their last NFA episode (old NFA>or= 5 years and recent NFA<4 years).


RESULTS
Characteristic features of the NFA group included severe disease (23.1%vs 7.6%) with more aggressive patient management, including inhaled corticosteroid use (84.3%vs 72.0%). Multiple regression analysis confirmed that aspirin-intolerant asthma (AIA) was strongly associated with NFA. There was no difference in the incidence of AIA between the recent and old NFA patients. This suggests the incidence of AIA in NFA did not improve over time.


CONCLUSIONS
A history of AIA may be a useful indicator of potential NFA and allow preventative methods to be introduced. It is therefore important to obtain a history of AIA and to be aware of the risk of NSAID administration to these patients.
Yoshimine
Fumitoshi
F
Niigata Asthma Treatment Study Group, Niigata University Hospital, Niigata, Japan.
Hasegawa
Takashi
T
Suzuki
Eiichi
E
Terada
Masaki
M
Koya
Toshiyuki
T
Kondoh
Ariyoshi
A
Arakawa
Masaaki
M
Yoshizawa
Hirohisa
H
Gejyo
Fumitake
F
D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012307:Risk Factors; D013224:Status Asthmaticus / Q000209:etiology*
D018927:Anti-Asthmatic Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin