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ENFUMOSA (courriel: Chanez (at) montp.inserm.fr ) The European Network For Understanding Mechanisms of Severe Asthma BIOMED 2 Program - European Commission 4th quaterly meeting, with the support of INSERM and Merck Sharp & Dhome Laboratory February 13-14th 1998 in Montpellier- France (see programm, abstracts and experts comments ) Long-term follow-up of severe asthmatic patients requiring mechanical ventilation B. Wallaert, E. Rivaud, A.B Tonnel. Clinique des Maladies Respiratoires. Service de Pneumologie ef Immuno-Allergologie, Hôpital A. CALMETTE et INSERM U416 INSTITUT PASTEUR - LILLE Vendredi 13Février 1998 Présentateurs Modérateurs Experts 8h30-10h00 Aspects cliniques Clincal aspects P. Godard (Montpellier) B. Wallaert (Lille) T. Perez (Lille) Discussion 15' 15' 15' 45' P. Duroux (Paris) C. Pison (Grenoble) E. Bel (Leiden, NL) S. Johnston (Southampton, UK) N. Siafakas (Heraklion, G) We assessed the long term mortality of severe asthmatics who underwent an episode of near-fatal asthma requiring mechanical ventilation between 1983 and 1988. Asthma was diagnosed according to the criteria of the American Thoracic Society. Heavy smokers and patients with a clinical history of chronic obstructive pulmonary disease were excluded from the study. Initial characteristics of the patients were obtained from medical charts. The cohort consisted in 147 patients. Baseline characteristics of the patients are shown in the table. Age : 45 + 18 years Duration of asthma : 23 + 14 years Patients previously hospitalized for asthma : 15% Number of previous hospitalisation : 3.6 + 3 Steroid-dependance of asthma : 29% Aspirin intolerance : 24.3% Smokers : 23.2%

Overall survival was 75.9 + 3.6% after 1 year, 66.9 + 3,9% after 5 years; 64.1 + 4% after 10 years and 47.4 + 7% after 14 years.

58/147 patients died during the follow-up period. 24 patients died during the first episode of mechanical ventilation; 34 patients died during the follow-up period; 38/34 of them died during an acute attack of asthma.

Age and steroid dependance were significant risk factors for death. Smoking did not clearly influence long term survival rate. The mean rate of rehospitalisation was 2.6 + 3.1; 16% patients experienced at least one other episode of mechanical ventilation for asthma. 12% were still smokers but smoking was not significantly correlated with the occurence of further hospitalisations after the first episode of mechanical ventilation.

Our study demonstrated that severe asthmatics presenting near fatal asthma requiring mechanical ventilation represented a subgroup of patients with a high risk of death.

. Asmanet ENFUMOSA Congrès Conçue et réalisée par: Michel Godard (at) Top
Date de création: 5 Décembre 1997-Dernière mise à jour: 23/07/98
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