Asthma mortality among Swedish children and young adults, a 10-year study.
BACKGROUND
Previous reports indicate that morbidity and mortality from asthma have increased during the past decades. Here, the mortality rate associated with asthma and possible risk factors in children and young adults in Sweden during the period 1994-2003 were evaluated.


METHODS
The medical profession was asked to report suspected cases of death from asthma in individuals 1-34 years of age. All death certificates containing relevant ICD codes were reviewed. Medical records and autopsy reports were assessed and telephone interviews with next-of-kin performed.


RESULTS
During the 10-year period 37 deaths due to asthma were identified. The median age at the time of death was 27 years and 6 of the deceased were younger than 15. The overall incidence of death from asthma decreased from 1.54 deaths per million in 1994 to 0.53 per million in 2003. Common risk factors were under-treatment (23/37), poor adherence to prescribed treatment (17/37) and adverse psychosocial situation (19/37). An alarming finding was that 11 of the 37 deaths were probably caused by food allergy and for 8 subjects death was associated with exposure to pet dander. The death certificates were found to contain inaccuracies with 30% of those for whom asthma was reported as the underlying cause having died from other causes.


CONCLUSIONS
Asthma mortality in children and young adults in Sweden decreased between 1994 and 2003. Food allergy and inadequate treatment were the major risk factors for such a death. Recognition and special care of patients with asthma who have shown signs of non-compliance, denial or severe food allergy must be encouraged.
Bergström
Sten-Erik
SE
Karolinska University Hospital, Pediatrics, Stockholm, Sweden. sten-erik.bergstrom@ki.se
Boman
Gunnar
G
Eriksson
Lars
L
Formgren
Hans
H
Foucard
Tony
T
Hörte
Lars-Gunnar
LG
Janson
Christer
C
Spetz-Nyström
Ulrike
U
Hedlin
Gunilla
G
D000293:Adolescent; D000328:Adult; D000818:Animals; D000829:Animals, Domestic; D001249:Asthma / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D005260:Female; D005512:Food Hypersensitivity / Q000401:mortality; D006801:Humans; D006967:Hypersensitivity / Q000401:mortality; D015994:Incidence; D007223:Infant; D008297:Male; D010349:Patient Compliance; D011584:Psychology; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult