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Vol. 42. Issue 10.
Pages 522-525 (October 2006)
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Vol. 42. Issue 10.
Pages 522-525 (October 2006)
Original Articles
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Is the Incidence of Near-Fatal Asthma Decreasing in Spain?
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Jesús Bellido Casadoa, Vicente Plazaa,
Corresponding author
vplaza@santpau.es

Correspondence: Dr. V. Plaza. Departament de Pneumologia. Hospital de la Santa Creu i Sant Pau. Sam Antoni M. Claret. 167.08025 Barcelona. España
, Santiago Bardagíb, Javier Cosanoc, Antolín Ló;pez Viñad, Eva Martínez Moragóne, Gema Rodríguez-Trigof, César Picadog, Joaquim Sanchisa
a Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
b Secció de Pneumologia, Hospital de Mataró, Mataró, Barcelona, Spain
c Servicio de Neumología, Hospital Reina Sofía, Córdoba, Spain
d Hospital Puerta de Hierro, Madrid, Spain
e Sección de Neumología, Hospital de Sagunto, Sagunto, Valencia, Spain
f Servicio de Neumología, Complejo Hospitalario Universitario Juan Canalejo, La Coruña, Spain
g Servei de Pneumologia i Al.lèrgia Respiratòria, Hospital Clínic, Barcelona, Spain
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Objective

A number of studies have shown that both mortality and hospital admissions due to severe asthma have decreased in recent years in many parts of the world. However, the situation is Spain has not yet been analyzed. The aim of this study was to determine the incidence of very severe, near-fatal asthma in recent years in various Spanish hospitals.

Patients and methods

A retrospective review of hospital records from 6 hospitals in 5 Spanish autonomous communities was conducted for the period 1997 to 2004 to determine the annual number of patients who required orotracheal intubation and mechanical ventilation due to an asthma attack.

Results

Of the 130 patients included in the study, 81 (62%) were women and 61 (47%) were aged between 51 and 75 years. The number of cases observed for the periods 2001–2002 and 2003–2004 (32 and 18, respectively) was significantly lower than that observed for the 1997–1998 and 1999–2000 periods (40 in both cases; P=.019). A significant increase in the incidence was observed in autumn and winter (n=81 [62%]; P=.018). Seventeen patients (13%) died and 8 (6%) developed serious sequelae.

Conclusions

Although our sample of 6 hospitals is not widely representative of the entire population of hospitals in Spain, our findings strongly suggest a decrease in the incidence of near-fatal asthma in Spain in recent years

Key words:
Asthma
Near-fatal asthma
Orotracheal intubation
Mechanical ventilation
Asthma epidemiology
Objetivo

Estudios recientes muestran un descenso de la mortalidad y del número de los ingresos hospitalarios por asma grave en los últimos años en diferentes lugares del mundo. Se desconoce la situación en nuestro país. El objetivo del presente estudio ha sido determinar la frecuencia anual de las crisis de asma de riesgo vital muy grave en los últimos años en diversos centros hospitalarios españoles.

Pacientes y métodos

Se revisaron retrospectivamente los registros hospitalarios de los pacientes que precisaron intubación orotraqueal y ventilación mecánica por una crisis de asma en 6 hospitales pertenecientes a 5 comunidades autónomas. El estudio recogió el número anual de casos observado durante el período comprendido entre 1997 y 2004.

Resultados

De los 130 pacientes incluidos, 81 (62%) eran mujeres y 61 (47%) tenían entre 51 y 75 años de edad. En los 2 últimos bienios (2001–2002 y 2003–2004) el número de pacientes recogidos (32 y 18, respectivamente) fue significativamente inferior al observado en los 2 primeros (1997–1998 y 1999–2000, con 40 cada bienio; p = 0,019). Se constató una incidencia significativamente mayor de casos (n = 81; 62%) durante las estaciones de otoño e invierno (p = 0,018). Fallecieron 17 pacientes (13%) y 8 (6%) presentaron secuelas graves.

Conclusiones

Si bien 6 centros hospitalarios no son lo bastante representativos de la totalidad de los centros españoles, los resultados del presente estudio podrían orientar hacia un muy probable descenso en nuestro país de los casos de asma de riesgo vital en los últimos años.

Palabras clave:
Asma
Asma de riesgo vital
Intubación orotraqueal
Ventilación mecánica
Epidemiología del asma
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REFERENCES
[1]
DM Mannino, DM Homa, LJ Akinbami, JE Moorman, C Gwynn, SC Redd.
Surveillance for asthma-United States, 1980–1999.
MMWR Morb Mortal Wkly Rep, 51 (2002), pp. 1-13
[2]
JA Lawson, A Senthilselvan.
Asthma epidemiology: has the crisis passed?.
Curr Opin Pulm Med, 11 (2005), pp. 79-84
[3]
RM Sly.
Decreases in asthma mortality in the United States.
Ann Allergy Asthma Immunol, 85 (2000), pp. 121-127
[4]
P Han, RP Cole.
Evolving differences in the presentation of severe asthma requiring intensive care unit admission.
Respiration, 71 (2004), pp. 458-462
[5]
H Neffen, C Baena-Cagnani, S Malka, D Sole, R Sepúlveda, L Caraballo, et al.
Asthma mortality in Latin America.
J Investig Allergol Clin Immunol, 7 (1997), pp. 249-253
[6]
LC Kuo, WY Shau, PC Yang, SH Kuo.
Trends in asthma mortality in Taiwan, 1981–2000.
J Formos Med Assoc, 102 (2003), pp. 534-538
[7]
JC Baluga, A Sueta, M Ceni.
Asthma mortality in Uruguay, 19841998.
Ann Allergy Asthma Immunol, 87 (2001), pp. 91-95
[8]
HJ Zar, D Stickells, A Toerien, D Wilson, M Klein, ED Bateman, et al.
Changes in fatal and near-fatal asthma in an urban area of South Africa from 1980–1997.
Eur Respir J, 18 (2001), pp. 33-37
[9]
T Haahtela, T Klaukka, K Koskela, M Erhola, LA Laitinen, on the behalf of the Working Group of the Asthma Programme in Finland 1994–2004.
Asthma programme in Finland: a community problem needs community solutions.
Thorax, 56 (2001), pp. 806-814
[10]
V Plaza, FJ Alvarez, P Casan, N Cobos, A López Viña, MA Llauger, et al.
en calidad de Comité Ejecutivo de la GEMA y en representación del grupo de redactores. Guía Española para el Manejo del Asma (GEMA).
Arch Bronconeumol, 39 (2003), pp. 1-42
[11]
Global Initiative for Asthma.
Global Strategy for Asthma Management and Prevention NHLBI/WHO Workshop Report.
[12]
S Suissa, P Ernst.
Inhaled corticosteroids: impact on asthma morbidity and mortality.
J Allergy Clin Immunol, 107 (2001), pp. 937-944
[13]
Grupo Español del Estudio Europeo del Asma.
Estudio Europeo del Asma. Prevalencia de hiperreactividad bronquial y asma en adultos jóvenes de cinco áreas españolas.
Med Clin (Barc), 106 (1996), pp. 761-767
[14]
Worldwide variations in the prevalence of asthma symptoms: the international study of asthma and allergies in childhood (ISAAC).
Eur Respir J, 12 (1998), pp. 315-335
[15]
G Julià Serdà, P Cabrera Navarro, O Acosta Fernández, P Martín Pérez, J Batista Martín, F Alamo Santana, et al.
High prevalence of asthma symptoms in the Canary Islands: climatic influence?.
J Asthma, 42 (2005), pp. 507-511
[16]
M Soler, L Chatenaud, E Nefri, C la Vecchia.
Trends in asthma mortality in Italy and Spain. 1980–1996.
Eur J Epidemiol, 17 (2001), pp. 545-549
[17]
V Plaza, J Serrano, C Picado, J Sanchis.
Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma.
Eur Respir J, 19 (2002), pp. 1-7
[18]
GA Viegi, I Annesi, G Matteelli.
Epidemiology of asthma.
Eur Respir Mon, 23 (2003), pp. 1-25
[19]
European Community Respiratory Health Survey.
Variations in the prevalence of respiratory symptoms, self-reported asthma attacks, and use of asthma medication in the European Community Health Study (ECRHS).
Eur Resp J, 9 (1996), pp. 687-695
[20]
RS Sunderland, DM Fleming.
Continuing decline in acute asthma episodes in the community.
Arch Dis Chile, 89 (2004), pp. 282-285
[21]
L von Hertzen, T Haahtela.
Signs of reversing trends in prevalence of asthma.
Allergy, 60 (2005), pp. 183-292
[22]
J Latvala, L von Hertzen, H Lindholm, T Haahtela.
Trends in prevalence of asthma and allergy in Finnish young men: nationwide study. 1966–2003.
[23]
KF Rabe, PA Vermeire, JB Soriano, WC Maier.
Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study.
Eur Respir J, 16 (2000), pp. 802-807
[24]
GJ Rodrigo, C Rodrigo, JB Hall.
Acute asthma in adults. A review.
Chest, 125 (2004), pp. 1081-1102
[25]
GJ Rodrigo, C Rodrigo, LJ Nannini.
Asma fatal o casi fatal: ¿entidad clínica o manejo inadecuado?.
Arch Bronconeumol, 40 (2004), pp. 24-33
[26]
Y Chen, P Stewart, H Johansen, L McRae, G Taylor.
Sex difference in hospitalization due to asthma in relation to age.
J Clin Epidemiol, 56 (2003), pp. 180-187
[27]
EJ Crighton, MM Mamdani, REG Upshur.
A population based time series analysis of asthma hospitalisations in Ontario, Canada: 1988 to 2000.
[28]
DM Fleming, KW Cross, R Sunderland, AM Ross.
Comparison of the seasonal patterns of asthma identified in general practitioner episodes, hospital admissions, and deaths.
Thorax, 55 (2000), pp. 662-665
[29]
RA Silverman, L Stevenson, HM Hastings.
Age-related seasonal patterns of emergency department visits for acute asthma in an urban environment.
Ann Emerg Med, 42 (2003), pp. 577-586
[30]
T Ringbaek, N Seersholm, K Viskum.
Standardised mortality rates in females and males with COPD and asthma.
Eur Respir J, 25 (2005), pp. 891-895

Study partially funded by grants from SEPAR (2004). La Marató de TV3 (2004), and Red Respira (RTIC-Instituto de Salud Carlos III and SEPAR).

Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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