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a Centre for Applied
Public Health Medicine, Cardiff, UK, b Llandough Hospital, Penarth, UK, c Princess Street Surgery,
Gorseinon, Swansea, UK, d Newport
Chest Clinic, Newport, UK, e The Surgery, High Street, Barry, UK, f East Glamorgan
Hospital, Church Village, UK
Correspondence to: Dr M L Burr, Centre for Applied Public Health Medicine, University of Wales College of Medicine, Temple of Peace and Health, Cathays Park, Cardiff CF1 3NW, UK.
Received 26 April 1999; Returned to authors 18 June 1999; Revised version received 12 July 1999; Accepted for publication 22 July 1999
BACKGROUND
Death from
asthma is regarded as preventable in principle, especially under the
age of 65 years.
METHODSIn 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.
RESULTSAsthma
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.
CONCLUSIONSSome
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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