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Is the death rate from asthma exaggerated? Evidence from west Cumbria
1West Cumberland Hospital, Whitehaven, Cumbria.
BMJ (Clinical Research Ed.)
|January 16, 1993
Summary
Reported asthma deaths in England and Wales may be overestimated. Clinical review of recorded asthma fatalities revealed alternative causes in over half of elderly, smoking patients, suggesting a much rarer actual asthma mortality rate.
Area of Science:
- Respiratory Medicine
- Epidemiology
- Public Health
Background:
- Official statistics report approximately 2000 annual asthma deaths in England and Wales.
- Clinical observations suggest the actual incidence of asthma-related mortality is significantly lower.
Purpose of the Study:
- To investigate the accuracy of reported asthma death rates.
- To determine the true mortality attributable to asthma in England and Wales.
Main Methods:
- Review of case notes for patients officially recorded as dying from asthma.
- Analysis of patient demographics, including age and smoking status.
- Identification of alternative causes of death.
Main Results:
- Many patients recorded as asthma deaths were over 60 and were cigarette smokers.
- An alternative cause of death was identified in over 50% of cases.
- Physicians in one health district recalled only seven asthma deaths over 14 years.
Conclusions:
- The reported mortality rate from asthma in England and Wales may be substantially inflated.
- Re-evaluation of death certification for asthma is warranted.
- Clinical data suggests a lower burden of asthma mortality than official figures indicate.