High in-hospital death rate with asthma flare


NEW YORK (Reuters Health) - As many as one-third of all deaths from asthma occur in patients who are hospitalized for asthma exacerbations, new research finds.

Such deaths occur as frequently in blacks and in whites, according to the study, and therefore the higher overall mortality in blacks due to asthma cannot be explained by hospitalization.

"Our findings suggest that improvements in the management of asthma exacerbations before hospitalization (e.g., at home, during transportation to the emergency department) will have the greatest benefit in further reducing the overall risk of death and in eliminating race disparities in asthma deaths," Dr. Jerry A. Krishnan, of the University of Chicago, and colleagues conclude.

Admission to the hospital for an asthma flare is common in the United States, but there are no national estimates of outcomes in this population. It is also not known if race disparities in asthma deaths exist among hospitalized patients.

Against this backdrop, Krishnan and colleagues analyzed 65,381 hospital admissions for asthma exacerbation among patients older than 5 years of age.

The in-hospital asthma death rate was 0.5 percent. The average hospital stay was 2.7 days, and the average hospital charge was $9078.

Of 4487 deaths from asthma, 1499 (33 percent) occurred in patients hospitalized for asthma exacerbations.

Black patients had a significantly lower risk of hospital mortality than white patients (0.3 percent versus 0.6 percent, respectively). Results of multivariable analyses revealed no significant race differences in hospital deaths.

American Journal of Respiratory and Critical Care Medicine, October 2006.