Prognosis
An estimated 450,000 American adults are admitted to an emergency room with asthma each year. The number of deaths from asthma increased from about 2,900 in 1908 to a high of 5,667 in 1996. The numbers appear to be declining slightly, and in 2002 about 4,260 people died because of asthma. Death from asthma is still a very uncommon event, considering that an estimated 20 million people in the U.S. have this condition. Most deaths from asthma, even when they occur in elderly adults, are preventable. It is very rare for a person who is receiving proper treatment to die of asthma. And studies suggest that the use of inhaled corticosteroids can reduce the risk for death by 90%. In spite of this and similar research, these important drugs are greatly underused.
Risk Factors for Very Severe or Fatal Asthma
About 55% of U.S. deaths from asthma occur among the elderly (over age 65), and an estimated 25% occur in adults aged 45 to 64. Women have a higher risk for fatal asthma than men. Being poor is also a significant risk factor for severe asthma. Hispanics and African Americans are at higher risk for death from asthma than Caucasians. Other specific risk factors for fatal asthma include:
- Previous history of respiratory failure
- Frequent visits to the emergency room
- Lack of continuous care and poor compliance with medications
- Having stopped treatment, particularly withdrawal from corticosteroids
- Having an emotional or psychiatric disorder. (Some evidence suggests that depression, anxiety, and stressful life situations can worsen asthma.)
- Being a drug abuser
- Being in a lower socioeconomic and educational group
Symptoms of a Life-Threatening Attack
The following signs and symptoms may indicate a life-threatening situation:
- As the chest labors to bring enough air into the lungs, breathing often becomes shallow.
- Lacking sufficient oxygen, the skin becomes bluish.
- The flesh around the ribs of the chest appears to be sucked in.
- The patient may begin to lose consciousness.
Asthma often progresses very slowly to a serious condition or may develop to a fatal or near-fatal attack within a few minutes. It is very difficult to predict when an attack will become very serious.
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