title: Clinical characteristics and prognosis in near-fatal asthma patients in Salvador, Brazil.
abstract: OBJECTIVE
  To determine the frequency of near-fatal asthma in a group of severe asthma patients, as well as the clinical characteristics and prognosis of these patients within a one-year follow-up period.
  
  
  METHODS
  A prospective study involving 731 low-income patients with severe asthma treated at a referral outpatient clinic located in the city of Salvador, Brazil. The patients were submitted to spirometry at admission, received medications for asthma, and were monitored regarding the frequency of asthma exacerbations during the follow-up period. A subsample of 511 patients also completed questionnaires regarding asthma symptoms and asthma-related quality of life.
  
  
  RESULTS
  Of the 731 patients studied, 563 (77%) were female. The median age was 47 years, and 12% were illiterate. Most of the patients had rhinitis, and 70 patients (10%) reported near-fatal asthma prior to admission. Of these 70 patients, 41 (59%) reported having been intubated previously. The patients reporting a history of near-fatal asthma at admission were more likely to have asthma exacerbations during the follow-up period and to respond poorly to therapy than were those not reporting such a history. At the end of the follow-up period, the scores on the two questionnaires were similar between the two groups of patients.
  
  
  CONCLUSIONS
  The frequency of near-fatal asthma was high in this group of low-income patients with severe asthma. The patients with a history of near-fatal asthma had a worse prognosis than did those without such a history, although both groups had received the same kind of treatment. Curiously, the intensity of symptoms and the quality of life at the end of the study were similar between the two groups.
authors: Center of Excellence in Asthma, Federal University of Bahia, Salvador, Brazil. evponte@yahoo.com.br
authors: Eduardo Vieira
authors: EV
authors: Ponte
authors: Adelmir
authors: A
authors: Souza-Machado
authors: Carolina
authors: C
authors: Souza-Machado
authors: Rosana
authors: R
authors: Franco
authors: Alvaro Augusto
authors: AA
authors: Cruz
mesh_terms: D000328:Adult; D017668:Age of Onset; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D001938:Brazil / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires