Vianello Andrea, Caminati Marco, Crivellaro Mariangiola, El Mazloum Rafi, Snenghi Rossella, Schiappoli Michele, Dama Annarita, Rossi Andrea, Festi Giuliana, Marchi Maria Rita, Bovo Chiara, Canonica Giorgio Walter, Senna Gianenrico
Respiratory Pathophysiology Division, University-City Hospital of Padua, Padua, Italy.
Asthma Center and Allergy Unit, Verona University and General Hospital, piazzale Stefani 1, 37126 Verona, Italy.
World Allergy Organ J. 2016 Dec 14;9(1):42. doi: 10.1186/s40413-016-0129-9. eCollection 2016.
Asthma mortality has declined since the 1980s. Nevertheless the World Health Organization (WHO) identified asthma as responsible for 225.000 deaths worldwide in 2005, and 430.000 fatal cases are expected by 2030. Some unexpected and concentrated fatal asthma events all occurred between 2013 and 2015 in Veneto, a North Eastern region of Italy, which prompted a more in-depth investigation of characteristics and risk factors.
A web search including key words related to fatal asthma in Italy between 2013 and 2015 has been performed. Concerning the cases that occurred in Veneto, subjects' clinical records have been evaluated and details about concomitant weather conditions, pollutants and pollen count have been collected.
Twenty-three cases of asthma deaths were found in Italy; 16 of them (69%) occurred in the Veneto Region. A prevalence of male and young age was observed. Most of patients were atopic, died in the night-time hours and during the weekends. The possible risk factors identified were the sensitization to , previous near fatal asthma attacks and the incorrect treatment of the disease. Weather condition did not appear to be related to the fatal exacerbations, whereas among the pollutants only ozone was detected over the accepted limits. Smoking habits, possible drug abuse and concomitant complementary therapies might be regarded as further risk factors.
Although not free from potential biases, our web search and further investigations highlight an increasing asthma mortality trend, similarly to what other observatories report. The analysis of available clinical data suggests that the lack of treatment more than a severe asthma phenotype characterizes the fatal events.
Asthma mortality still represents a critical issue in the management of the disease, particularly in youngsters. Once more the inadequate treatment and the lack of adherence seem to be not only related to the uncontrolled asthma but also to asthma mortality.
自20世纪80年代以来，哮喘死亡率有所下降。然而，世界卫生组织（WHO）指出，2005年全球有22.5万人死于哮喘，预计到2030年将有43万例致命病例。2013年至2015年期间，意大利东北部威尼托地区发生了一些意外且集中的致命哮喘事件，这促使人们对其特征和风险因素进行更深入的调查。
进行了一次网络搜索，搜索关键词为2013年至2015年期间意大利与致命哮喘相关的内容。对于威尼托地区发生的病例，评估了受试者的临床记录，并收集了有关伴随天气状况、污染物和花粉计数的详细信息。
在意大利发现了23例哮喘死亡病例；其中16例（69%）发生在威尼托地区。观察到男性和年轻人的患病率较高。大多数患者为特应性体质，在夜间和周末死亡。确定的可能风险因素包括对……过敏、既往接近致命的哮喘发作以及疾病治疗不当。天气状况似乎与致命性加重无关，而在污染物中，仅检测到臭氧超过了可接受的限值。吸烟习惯、可能的药物滥用和伴随的辅助治疗可能被视为进一步的风险因素。
尽管存在潜在偏差，但我们的网络搜索和进一步调查凸显出哮喘死亡率呈上升趋势，这与其他观察机构的报告相似。对现有临床数据的分析表明，致命事件的特征是缺乏治疗而非严重的哮喘表型。
哮喘死亡率仍是该疾病管理中的一个关键问题，尤其是在年轻人中。治疗不足和缺乏依从性似乎不仅与哮喘控制不佳有关，还与哮喘死亡率有关。
