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Time trends in 30 day case-fatality following hospitalisation for asthma in adults in Scotland: A retrospective cohort study from 1981 to 2009
- Source :
- Respiratory Medicine. 107(8):1172-1177
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- Summary Background The risk of case-fatality following hospitalisation for asthma has not been well characterised. We describe trends in 30 day case-fatality following hospitalisation for asthma in adults in Scotland from 1981 to 2009. Methods Using the Scottish Morbidity Record Scheme (SMR01) with all asthma hospitalisations for adults (≥18 years) with ICD9 493 and ICD10 J45–J46 in the principal diagnostic position at discharge (1981–2009). These data were linked to mortality data from the General Register Office for Scotland (GROS), with asthma case-fatality defined as death within 30 days of asthma admission (in or out of hospital). Logistic regression was used to explore the impact of age, sex, previous asthma admission (in the 12 months prior to hospitalisation), socioeconomic deprivation, year of admission and co-morbidity on 30-day case-fatality. Results There were a total of 116 457 asthma hospitalisations; a total of 1000 (0.9%) hospitalisations resulted in a post-admission death (within 30 days of admission). Odds ratios for unadjusted and adjusted case-fatality showed a decreased risk of case-fatality from the mid-1990s onwards when compared to case-fatality in 1981. Advancing age and co-morbid diagnoses of respiratory failure, cancer, renal failure, cor pulmonale, coronary heart disease and respiratory infection were associated with increased likelihood of death. Conclusions 30 day case-fatality has declined over the last three decades, comparable to case-fatality reported in other parts of the UK. This decline may be in part due to improved guidelines, protocols and disease management for asthma over the last 30 years. The likelihood of death 30 days following an asthma admission increased with age group and was associated with respiratory failure, renal failure and cancer.
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Pediatrics
Adolescent
Epidemiology
Comorbidity
Logistic regression
Young Adult
Age Distribution
Risk Factors
Cause of Death
Case fatality rate
medicine
Humans
Sex Distribution
Asthma
Aged
Retrospective Studies
business.industry
Respiratory infection
Asthma mortality
Retrospective cohort study
Odds ratio
Middle Aged
medicine.disease
Hospitalisations
Hospitalization
Respiratory failure
Scotland
Female
business
Asthma trends
Subjects
Details
- ISSN :
- 09546111
- Volume :
- 107
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Respiratory Medicine
- Accession number :
- edsair.doi.dedup.....3fbcde80ea678e4fd83a5f83ada1adfe
- Full Text :
- https://doi.org/10.1016/j.rmed.2013.04.004