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Mortality from asthma in Western Australia
A W Musk1, G F Ryan, D M Perera
1Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, Nedlands, WA.
Insights
Asthma patients face significantly higher mortality risks from asthma, chronic airflow obstruction, and ischemic heart disease. These findings highlight asthma as a potentially fatal condition requiring ongoing medical attention.
Area of Science:
- Respiratory Medicine
- Epidemiology
- Public Health
Background:
- Asthma is a chronic respiratory condition affecting millions globally.
- Understanding long-term mortality risks associated with asthma is crucial for public health management.
Purpose of the Study:
- To investigate the mortality risks associated with asthma in a large patient cohort.
- To identify specific causes of death and age-related trends in asthma patients.
Main Methods:
- Retrospective cohort study analyzing hospital discharge data from Western Australia (1976-1980).
- Follow-up data collected until 1982 to identify all-cause and cause-specific mortality.
- Calculation of Standardized Mortality Ratios (SMR) to compare observed deaths against expected rates.
Main Results:
- A cohort of 10,739 asthma patients (5760 male, 4979 female) was analyzed.
- Significantly elevated all-cause mortality was observed in both men (SMR 1.6) and women (SMR 1.7).
- Increased mortality was linked to asthma (SMR 57.9), chronic airflow obstruction (SMR 9.3), and ischemic heart disease (SMR 1.3), with excess asthma deaths across all ages.
Conclusions:
- Asthma is associated with a substantially increased risk of premature death from asthma itself and related conditions.
- Chronic airflow obstruction and ischemic heart disease contribute to excess mortality in asthma patients, particularly in older age groups.
- The findings underscore the potentially fatal nature of asthma and suggest a link between asthma and irreversible airflow obstruction.
Abstract:
From a cohort of all 5760 male and 4979 female patients who were admitted to WA hospitals and were discharged with a diagnosis of asthma between 1976 and 1980, 265 deaths in men and 189 deaths in women were identified by the end of 1982. The standardized mortality ratio (SMR) for all causes of death for this cohort was 1.6 for men (P less than 0.001) and 1.7 for women (P less than 0.001). Both sexes showed a significant increase in deaths that were attributable to asthma (SMR, 57.9), chronic airflow obstruction (SMR, 9.3) and ischaemic heart disease (SMR, 1.3). The excess death rates for asthma were observed in all age groups, but those for chronic airflow obstruction and ischaemic heart disease were present in older age groups only. These findings indicate that asthma remains a potentially fatal disease in the Australian community. The excess mortality ratios for chronic airflow obstruction that were observed in patients who were admitted to hospital with asthma also suggest that asthma may result in irreversible airflow obstruction.