Never Ignore the Severity of an Asthma Exacerbation
Determining your risk for a fatal asthma attack is important. Only 33% of asthma deaths occur in the hospital -- which means many asthma patients who die are either not seeking care or are not being hospitalized with their worsening asthma. Asthma exacerbations can be life threatening and can occur in anyone with mild to severe asthma.
Patients at high risk of asthma related death require intensive education and special care. Make sure you know if you are in one of the increased risk groups discussed below.
Importantly, 80 to 85% who die from asthma develop progressive symptoms anywhere from 12 hours to several weeks before death. Only 15 to 20% die in less than 6 hours after developing symptoms. Thus, the vast majority of patients dying from asthma developed symptoms in a time frame that would have allowed them to seek appropriate medical care.
Risk Factors for Asthma Related Death
All of the following are risk factors for asthma related death:
- Previous history of a near-fatal asthma event
- Recent poorly controlled asthma with increased shortness of breath, nocturnal awakenings, and rescue inhaler use
- Prior severe asthma exacerbation where you were intubated or admitted to an intensive care unit.
- Two or more asthma-related hospital admissions or three or more visits to the emergency room for asthma
- Using 2 or more canisters of your short acting bronchodilator like albuterol in a month
- If you have trouble identifying when your asthma symptoms are worsening or you are having an asthma attack
- Being poor and from the inner city
- Substance abuse
- Significant psychiatric disease
- Other significant medical problems like a heart attack and other lung diseases
What Do I Do if I am at Increased Risk?All of the following may help you reduce your risk of an asthma related death:
- Know that you are at risk
- Know your asthma action plan
- Make sure you understand your asthma action plan
- Use your asthma action plan
- Use your peak flow meter regularly
- Do not delay seeking emergency care if your symptoms worsen
- Tell your asthma care provider that you are at increased risk of an asthma related death
- Make sure you can effectively communicate with an asthma care provider
National Heart, Lung, and Blood Institute. Accessed: January 1, 2009. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma
Identifying Patients at Risk for Fatal Asthma. UptoDate Accessed March 13, 2009.