Ormerod L P, Stableforth D E
Br Med J. 1980 Mar 8;280(6215):687-90. doi: 10.1136/bmj.280.6215.687.
Out of 83 patients studied 72 were certified as dying from asthma, and 11 aged under 45 as dying from chronic bronchitis and pneumonia. Fifty-three deaths were thought to be due to asthma. There were avoidable factors associated with several of these deaths from asthma. Recent discharge from hospital (16%), non-availability of aerosol bronchodilators (45%), underuse of corticosteroids (66%), and lack of objective measurements of airflow obstruction (100%) were found in deaths outside hospital. Inadequate initial assessment including baseline spirometry and blood gases (50%), significant underusage of corticosteroids (93%) and intravenous and nebulised bronchodilators (100%), and failure to monitor treatment objectively (100%) were found in deaths in hospital. "False-positive" and "false-negative" certifications of asthma were studied, and the findings suggest that these may lead to appreciable inaccuracy in the reporting of deaths from asthma.
在研究的83例患者中，72例被确认为死于哮喘，11例45岁以下患者死于慢性支气管炎和肺炎。53例死亡被认为是由哮喘所致。其中几例哮喘死亡存在可避免的因素。在院外死亡病例中发现，近期出院（16%）、无雾化支气管扩张剂可用（45%）、皮质类固醇使用不足（66%）以及缺乏气流受限的客观测量（100%）。在院内死亡病例中发现，初始评估不充分，包括基线肺功能测定和血气分析（50%）、皮质类固醇显著使用不足（93%）以及静脉和雾化支气管扩张剂使用不足（100%），且未能客观监测治疗（100%）。对哮喘的“假阳性”和“假阴性”认证进行了研究，结果表明这些可能导致哮喘死亡报告出现明显不准确。
