Causes of death in asthma patients enrolled in the Bahia State Program for the Control of Asthma and Allergic Rhinitis.
OBJECTIVE
To report demographic and clinical characteristics of patients with asthma who evolved to death, as well as to describe the conditions related to this outcome in a subgroup of patients admitted to the Program for the Control of Asthma and Rhinitis in Bahia (ProAR).


METHODS
A descriptive, retrospective, observational study. Data from clinical charts and death certificates of 16 patients of 930 subjects with severe asthma monitored at the ProAR Central Reference Center from December 2003 to June 2006 were reviewed.


RESULTS
Of the 930 patients participating in the program, 16 (1.72%) died. Of these, there were 10 males and 6 females, ranging in age from 39 to 74 years (median, 55 years); 12 (75%) of the patients were black. Time since diagnosis ranged from 1 to 68 years (median, 30 years). In 43.8 and 53.8%, respectively, there was a personal or family history of atopy. Ex-smokers (<10 pack-years) accounted for 37.5% of the cases. Causes of death listed on the death certificates were as follows: asthma or asthma exacerbations in 8 (50%); respiratory failure in 3 (18.75%); acute heart infarction in 2 (12.5%); hepatitis in 1 (6.25%); hypovolemic shock in 1 (6.25%); and cardiorespiratory arrest in 1 (6.25%). Of the 16 deaths, 13 (81.25%) occurred inside hospitals.


CONCLUSIONS
Asphyxia and cardiovascular diseases were the most common attributed causes of mortality in this subgroup of patients with severe asthma. Hospital-based mortality, male gender, advanced age, long-term disease and fixed airflow obstruction were the aspects most frequently observed in the cases studied.
Souza-Machado
Adelmir
A
Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brasil. adelmirm@terra.com.br
Souza-Machado
Carolina
C
Silva
Daisy Freitas
DF
Ponte
Eduardo Vieira
EV
Cruz
Alvaro A
AA
D000328:Adult; D000367:Age Factors; D000368:Aged; D001237:Asphyxia / Q000150:complications; D001249:Asthma / Q000401:mortality* / Q000503:physiopathology; D001938:Brazil; D002318:Cardiovascular Diseases / Q000150:complications; D002423:Cause of Death; D003266:Continuity of Patient Care; D004812:Epidemiologic Methods; D005260:Female; D020022:Genetic Predisposition to Disease; D006078:Government Programs; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012220:Rhinitis / Q000628:therapy; D012737:Sex Factors; D013997:Time Factors