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Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark.

Gullach AJ, Risgaard B, Lynge TH, Jabbari R, Glinge C, Haunsø S, Backer V, Winkel BG, Tfelt-Hansen J - BMC Pulm Med (2015)

Bottom Line: Through the review of death certificates, we found 625 sudden unexpected death cases in individuals aged 1-35 years in Denmark from 2000 to 2006.The cause of death was predominantly sudden cardiac death followed by fatal asthma attack.We found that 41 (84%) of patients suffered from symptoms prior to death and that 28 (57%) sought medical advice from the emergency department and/or general practitioners.

View Article: PubMed Central - PubMed

Affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. anders_gullach@hotmail.com.

ABSTRACT

Background: Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled asthma as a previous hospital admittance because of asthma (of any severity) or when asthma was considered to have influenced the death according to the death certificate. The purpose of this study is to increase the medical focus on young persons with uncontrolled asthma and thereby hopefully aid in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma.

Methods: Through the review of death certificates, we found 625 sudden unexpected death cases in individuals aged 1-35 years in Denmark from 2000 to 2006. Of those, 49 persons with uncontrolled asthma were identified. Previous contacts with the healthcare system were identified, and available records from general practitioners were retrieved.

Results: We identified 49 individuals who suffered from uncontrolled asthma. This corresponds to an incidence rate of 0.32 per 100,000 person-years. The cause of death in 31 cases (63%) was sudden cardiac death, and in 13 cases (27%), it was a fatal asthma attack. Symptoms (chest pain, dyspnea, seizures, general malaise, syncope, and palpitations) prior to death were reported in 41 (84%) of the cases. In 34 (69%) of the cases, antecedent symptoms (symptoms >24 hours before death) were present, and 28 (57%) patients had prodromal symptoms (symptoms <24 hours before death). The most common antecedent symptoms were dyspnea and chest pain, whereas the most common prodromal symptoms were dyspnea, general malaise, and/or fatigue. Twenty-eight patients (57%) sought medical advice from a general practitioner and/or emergency department due to these symptoms.

Conclusion: The cause of death was predominantly sudden cardiac death followed by fatal asthma attack. We found that 41 (84%) of patients suffered from symptoms prior to death and that 28 (57%) sought medical advice from the emergency department and/or general practitioners.

No MeSH data available.


Related in: MedlinePlus

Cause of death, flowchart.
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Fig1: Cause of death, flowchart.

Mentions: We have previously identified all SD cases in individuals aged 1–35 years in Denmark from 2000 to 2006 [8]. In brief, this was a nationwide retrospective study using the availability of all death certificates and the registration of all inpatient and outpatient activity in Danish hospitals and emergency departments (ED) together with access to all medical records and autopsy reports, as previously described in detail by Winkel et al. [8]. All death certificates were retrieved electronically and were read independently by two physicians to identify all SD cases. For the purpose of this study, we included only those SD cases occurring in persons with uncontrolled asthma (see Figure 1).Figure 1


Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark.

Gullach AJ, Risgaard B, Lynge TH, Jabbari R, Glinge C, Haunsø S, Backer V, Winkel BG, Tfelt-Hansen J - BMC Pulm Med (2015)

Cause of death, flowchart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4404085&req=5

Fig1: Cause of death, flowchart.
Mentions: We have previously identified all SD cases in individuals aged 1–35 years in Denmark from 2000 to 2006 [8]. In brief, this was a nationwide retrospective study using the availability of all death certificates and the registration of all inpatient and outpatient activity in Danish hospitals and emergency departments (ED) together with access to all medical records and autopsy reports, as previously described in detail by Winkel et al. [8]. All death certificates were retrieved electronically and were read independently by two physicians to identify all SD cases. For the purpose of this study, we included only those SD cases occurring in persons with uncontrolled asthma (see Figure 1).Figure 1

Bottom Line: Through the review of death certificates, we found 625 sudden unexpected death cases in individuals aged 1-35 years in Denmark from 2000 to 2006.The cause of death was predominantly sudden cardiac death followed by fatal asthma attack.We found that 41 (84%) of patients suffered from symptoms prior to death and that 28 (57%) sought medical advice from the emergency department and/or general practitioners.

View Article: PubMed Central - PubMed

Affiliation: Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark. anders_gullach@hotmail.com.

ABSTRACT

Background: Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled asthma as a previous hospital admittance because of asthma (of any severity) or when asthma was considered to have influenced the death according to the death certificate. The purpose of this study is to increase the medical focus on young persons with uncontrolled asthma and thereby hopefully aid in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma.

Methods: Through the review of death certificates, we found 625 sudden unexpected death cases in individuals aged 1-35 years in Denmark from 2000 to 2006. Of those, 49 persons with uncontrolled asthma were identified. Previous contacts with the healthcare system were identified, and available records from general practitioners were retrieved.

Results: We identified 49 individuals who suffered from uncontrolled asthma. This corresponds to an incidence rate of 0.32 per 100,000 person-years. The cause of death in 31 cases (63%) was sudden cardiac death, and in 13 cases (27%), it was a fatal asthma attack. Symptoms (chest pain, dyspnea, seizures, general malaise, syncope, and palpitations) prior to death were reported in 41 (84%) of the cases. In 34 (69%) of the cases, antecedent symptoms (symptoms >24 hours before death) were present, and 28 (57%) patients had prodromal symptoms (symptoms <24 hours before death). The most common antecedent symptoms were dyspnea and chest pain, whereas the most common prodromal symptoms were dyspnea, general malaise, and/or fatigue. Twenty-eight patients (57%) sought medical advice from a general practitioner and/or emergency department due to these symptoms.

Conclusion: The cause of death was predominantly sudden cardiac death followed by fatal asthma attack. We found that 41 (84%) of patients suffered from symptoms prior to death and that 28 (57%) sought medical advice from the emergency department and/or general practitioners.

No MeSH data available.


Related in: MedlinePlus