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December 1980

Life-Threatening Asthma

Author Affiliations

From the Pulmonary Division, Department of Medicine, Albert Einstein College of Medicine, and the Chest Service, Department of Medicine, Bronx Municipal Hospital Center, New York.

Arch Intern Med. 1980;140(12):1604-1605. doi:10.1001/archinte.1980.00330230050013

• I review my experience with life-threatening asthma, defined as hypercapnia, need for intubation, or death, at a large municipal hospital during a ten-year period. Such severe illness is rare among asthmatics and predicting its occurrence is difficult. Eighty patients had 111 admissions for life-threatening asthma; 773 patients were hospitalized for asthma 851 times during the study period. Only 15% of these 773 patients had experienced severe asthma previously and the duration of asthma and frequency of hospitalization was similar to that of the other patients admitted for asthma. Follow-up study of the survivors of life-threatening asthma has revealed a very high rate of recurrence. More than 35% had a recurrence in one to ten years, and those who had three to four episodes had a recurrence rate of 45% and 60%, respectively. Although life-threatening asthma is rare, unpredictable, and occurs only after many years of symptomatic illness, once it does occur there is a real risk of recurrence. Patients who have experienced such a severe episode of asthma require continuing careful supervision and management.

(Arch Intern Med 140:1604-1605, 1980)