Chest
Clinical CommentaryInternational Trends in Asthma Mortality Rates in the 5- to 34-Year Age Group: A Call for Closer Surveillance
Section snippets
Materials and Methods
To be included in the analysis, countries had to have data available prior to 1980 to ensure that long-term trends in mortality could be determined. In accordance with standard practice, asthma mortality rates have been confined to the 5- to 34-year age group because the correct assignment of asthma mortality is firmly established in this group.14 Although most deaths occur in the older age group, the accuracy of asthma as the cause of death progressively declines with increasing age because of
Results
Figure 1 shows asthma mortality rates for the 20 countries included in the analysis and the smoothed fit with 90% confidence intervals. The data set of the asthma mortality rates for the individual countries per year is shown in Table 1. There was a mean 53% increase in asthma mortality rates from 0.55 per 100,000 in 1960 and 1961 to a peak of 0.84 per 100,000 in 1966 and 1967 (see Table E1 in online supplementary material). This trend was followed by a progressive decline to a nadir of 0.45
Discussion
Death from asthma is a complex phenomenon, and many factors relevant to the cause of asthma mortality have changed in different degrees in different countries during the period studied. Despite this complexity, it is possible to propose a unifying hypothesis to explain these international time trends, namely that they predominantly relate to changes in drug treatment.
It is well recognized that epidemics of asthma mortality occurred in at least six countries in the 1960s due to the widespread
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Dr. Beasley has been a member of the GlaxoSmithKline and Novartis International Advisory Boards and has received research funding from GlaxoSmithKline, Novartis, and MedSafe (New Zealand government). No conflict of interest exists for the other authors.
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