Asthma deaths in Cardiff 1963-74: 53 deaths in hospital

In a study of factors associated with death from bronchial asthma in hospital 53 patients were investigated. Typically the fatal attack persisted for several days before admission to hospital and normally occurred in patients with a long history of asthma. The patient or doctor often underestimated the severity of the attack. On admission most patients were severely ill, and over a third died within 24 hours. Peak flow rate and blood gases were rarely measured. Corticosteroid treatment was often underused, and patients rarely received assisted ventilation before death. Infection played a part in 14 deaths, five of them associated with assisted ventilation. Admitting asthmatics to a special respiratory ward with facilities for standardised assessment and treatment and introducing a self-admission service may help to prevent some of these deaths.