Sears M R, Rea H H, Rothwell R P, O'Donnell T V, Holst P E, Gillies A J, Beaglehole R
Br Med J (Clin Res Ed). 1986 Nov 22;293(6558):1342-5. doi: 10.1136/bmj.293.6558.1342.
Causes for the high mortality from asthma in New Zealand were investigated by comparing deaths from asthma in caucasian subjects aged 15-64 in New Zealand with those from asthma in the same age group in two regions in England. There were no significant differences in the accuracy of death certification. The verified asthma mortality in New Zealand (4.2/100,000) was over twice that in England. Many characteristics of patients and management, including poor compliance with treatment and deficiencies in long term and emergency care, were qualitatively similar in the two countries. New Zealand had an apparently higher rate of non-preventable deaths from asthma, suggesting a greater severity of asthma in New Zealand. In both countries, however, most deaths were associated with poor assessment, underestimation of severity and inappropriate treatment (over-reliance on bronchodilators and underuse of systemic corticosteroids), and delays in obtaining help. A greater frequency of some of these deficiencies in management remains a possible additional explanation for part of the excess mortality in New Zealand.
通过比较新西兰15至64岁白种人哮喘死亡情况与英格兰两个地区同年龄组哮喘死亡情况，对新西兰哮喘高死亡率的原因进行了调查。死亡证明的准确性没有显著差异。新西兰经核实的哮喘死亡率（4.2/10万）是英格兰的两倍多。两国患者的许多特征及管理情况，包括治疗依从性差以及长期和急诊护理不足，在性质上相似。新西兰哮喘不可预防死亡的发生率明显较高，表明新西兰哮喘病情更严重。然而，在这两个国家，大多数死亡都与评估不佳、对严重程度估计不足、治疗不当（过度依赖支气管扩张剂和全身性皮质类固醇使用不足）以及寻求帮助延迟有关。管理中这些不足情况出现的频率更高，这仍然可能是新西兰部分超额死亡率的一个额外解释。
