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. 1999 Nov;54(11):985–989. doi: 10.1136/thx.54.11.985

A confidential inquiry into asthma deaths in Wales

M Burr 1, B Davies 1, A Hoare 1, A Jones 1, I Williamson 1, S Holgate 1, R Arthurs 1, I Hodges 1
PMCID: PMC1745402  PMID: 10525556

Abstract

BACKGROUND—Death from asthma is regarded as preventable in principle, especially under the age of 65years.
METHODS—In 1994 a confidential inquiry was set up to investigate deaths attributable to asthma in residents of Wales under the age of 65 years. During the period of the inquiry 92 cases were notified as being ascribed to asthma, or (in 1996) having a mention of asthma on the death certificate. Of these, 80 were investigated further with the help of general practitioners, hospital notes, and relatives. The details were then considered by a small panel of doctors who endeavoured to identify factors that may have contributed to the deaths.
RESULTS—Asthma was considered to be the underlying cause of 52 deaths. Although disease severity was usually a major factor, some aspect of the patient's behaviour or circumstances seemed to have contributed to 31 deaths, while in 15 cases there was probably a deficiency in medical care.
CONCLUSIONS—Some preventable asthma deaths still occur, particularly in relation to inadequate treatment. Factors associated with patients' behaviour and circumstances are more difficult to tackle but, if doctors are aware of high risk patients, increased vigilance may prevent some deaths.



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Selected References

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  1. Campbell D. A., McLennan G., Coates J. R., Frith P. A., Gluyas P. A., Latimer K. M., Luke C. G., Martin A. J., Roder D. M., Ruffin R. E. A comparison of asthma deaths and near-fatal asthma attacks in South Australia. Eur Respir J. 1994 Mar;7(3):490–497. doi: 10.1183/09031936.94.07030490. [DOI] [PubMed] [Google Scholar]
  2. Charlton J., Lakhani A., Aristidou M. How have 'avoidable death' indices for England and Wales changed? 1974-78 compared with 1979-83. Community Med. 1986 Nov;8(4):304–314. [PubMed] [Google Scholar]
  3. Guite H. F., Burney P. G. Accuracy of recording of deaths from asthma in the UK: the false negative rate. Thorax. 1996 Sep;51(9):924–928. doi: 10.1136/thx.51.9.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Joseph K. S., Blais L., Ernst P., Suissa S. Increased morbidity and mortality related to asthma among asthmatic patients who use major tranquillisers. BMJ. 1996 Jan 13;312(7023):79–82. doi: 10.1136/bmj.312.7023.79. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. MacDonald J. B., MacDonald E. T., Seaton A., Williams D. A. Asthma deaths in Cardiff 1963-74: 53 deaths in hospital. Br Med J. 1976 Sep 25;2(6038):721–723. doi: 10.1136/bmj.2.6038.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Macdonald J. B., Seaton A., Williams D. A. Asthma deaths in Cardiff 1963-74: 90 deaths outside hospital. Br Med J. 1976 Jun 19;1(6024):1493–1495. doi: 10.1136/bmj.1.6024.1493. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Model D. Preventable factors and death certification in death due to asthma. Respir Med. 1995 Jan;89(1):21–25. doi: 10.1016/0954-6111(95)90066-7. [DOI] [PubMed] [Google Scholar]
  8. Mohan G., Harrison B. D., Badminton R. M., Mildenhall S., Wareham N. J. A confidential enquiry into deaths caused by asthma in an English health region: implications for general practice. Br J Gen Pract. 1996 Sep;46(410):529–532. [PMC free article] [PubMed] [Google Scholar]
  9. Smyth E. T., Wright S. C., Evans A. E., Sinnamon D. G., MacMahon J. Death from airways obstruction: accuracy of certification in Northern Ireland. Thorax. 1996 Mar;51(3):293–297. doi: 10.1136/thx.51.3.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Strunk R. C., Mrazek D. A., Fuhrmann G. S., LaBrecque J. F. Physiologic and psychological characteristics associated with deaths due to asthma in childhood. A case-controlled study. JAMA. 1985 Sep 6;254(9):1193–1198. [PubMed] [Google Scholar]
  11. Wareham N. J., Harrison B. D., Jenkins P. F., Nicholls J., Stableforth D. E. A district confidential enquiry into deaths due to asthma. Thorax. 1993 Nov;48(11):1117–1120. doi: 10.1136/thx.48.11.1117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Westerling R. Trends in "avoidable" mortality in Sweden, 1974-1985. J Epidemiol Community Health. 1992 Oct;46(5):489–493. doi: 10.1136/jech.46.5.489. [DOI] [PMC free article] [PubMed] [Google Scholar]

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