Bergström Sten-Erik, Boman Gunnar, Eriksson Lars, Formgren Hans, Foucard Tony, Hörte Lars-Gunnar, Janson Christer, Spetz-Nyström Ulrike, Hedlin Gunilla
Karolinska University Hospital, Pediatrics, Stockholm, Sweden.
Respir Med. 2008 Sep;102(9):1335-41. doi: 10.1016/j.rmed.2008.03.020. Epub 2008 Jul 17.
Previous reports indicate that morbidity and mortality from asthma have increased during the past decades. Here, the mortality rate associated with asthma and possible risk factors in children and young adults in Sweden during the period 1994-2003 were evaluated.
The medical profession was asked to report suspected cases of death from asthma in individuals 1-34 years of age. All death certificates containing relevant ICD codes were reviewed. Medical records and autopsy reports were assessed and telephone interviews with next-of-kin performed.
During the 10-year period 37 deaths due to asthma were identified. The median age at the time of death was 27 years and 6 of the deceased were younger than 15. The overall incidence of death from asthma decreased from 1.54 deaths per million in 1994 to 0.53 per million in 2003. Common risk factors were under-treatment (23/37), poor adherence to prescribed treatment (17/37) and adverse psychosocial situation (19/37). An alarming finding was that 11 of the 37 deaths were probably caused by food allergy and for 8 subjects death was associated with exposure to pet dander. The death certificates were found to contain inaccuracies with 30% of those for whom asthma was reported as the underlying cause having died from other causes.
Asthma mortality in children and young adults in Sweden decreased between 1994 and 2003. Food allergy and inadequate treatment were the major risk factors for such a death. Recognition and special care of patients with asthma who have shown signs of non-compliance, denial or severe food allergy must be encouraged.
先前的报告表明，在过去几十年中，哮喘的发病率和死亡率有所上升。在此，对1994 - 2003年期间瑞典儿童和年轻人中与哮喘相关的死亡率及可能的风险因素进行了评估。
要求医疗行业报告1 - 34岁个体中疑似哮喘死亡病例。审查了所有包含相关国际疾病分类（ICD）代码的死亡证明。评估了医疗记录和尸检报告，并对近亲进行了电话访谈。
在这10年期间，共确定了37例哮喘死亡病例。死亡时的中位年龄为27岁，其中6名死者年龄小于15岁。哮喘的总体死亡率从1994年的每百万1.54例死亡降至2003年的每百万0.53例。常见的风险因素包括治疗不足（23/37）、对规定治疗的依从性差（17/37）和不良的社会心理状况（19/37）。一个令人担忧的发现是，37例死亡中有11例可能是由食物过敏引起的，8名受试者的死亡与接触宠物皮屑有关。发现死亡证明存在不准确之处，在那些报告哮喘为根本死因的人中，有30%实际上死于其他原因。
1994年至2003年期间，瑞典儿童和年轻人的哮喘死亡率有所下降。食物过敏和治疗不足是此类死亡的主要风险因素。必须鼓励对有不依从、否认或严重食物过敏迹象的哮喘患者进行识别和特别护理。
