The Risk of a Fatal Asthma Attack

Identifiying and Preventing Fatal Asthma

Woman taking asthma inhaler
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Fatal asthma is a significant problem with more than 10 Americans dying each day from asthma. Even though death rates have declined in the past decade, any asthma death is potentially preventable. Learn how to reduce your risks.

Never Ignore the Severity of an Asthma Exacerbation

Determining your risk for a fatal asthma attack is important. Only a third of asthma deaths occur in the hospital, which means many asthma patients who die are either not seeking care or are not being hospitalized with their worsening asthma.

Asthma and every attack have the potential to be life threatening. Fatal asthma can occur in anyone with mild intermittent to more severe asthma.

Patients at high risk of asthma-related death require intensive education and special care. Make sure you know if you are in one of the increased risk groups discussed below.

Importantly, 80 to 85 percent who die from asthma develop progressive symptoms anywhere from 12 hours to several weeks before death. Only 15 to 20 percent die in less than 6 hours after developing symptoms. Thus, the vast majority of patients dying from asthma developed symptoms in a time frame that would have allowed them to seek appropriate medical care.

Risk Factors for Asthma-Related Death

All of the following are risk factors for asthma-related death:

  • Previous history of a near-fatal asthma event
  • Recent poorly controlled asthma with increased shortness of breath, nocturnal awakenings, and rescue inhaler use
  • Prior severe asthma exacerbation where you were intubated or admitted to an intensive care unit.
  • Two or more asthma-related hospital admissions or three or more visits to the emergency room for asthma
  • Using two or more canisters of your short-acting bronchodilator like albuterol in a month
  • If you have trouble identifying when your asthma symptoms are worsening or you are having an asthma attack
  • Being poor and from the inner city
  • Substance abuse
  • Significant psychiatric disease
  • Other significant medical problems like a heart attack and other lung diseases

Two-thirds of all asthma deaths are women. African-Americans, in general, are three times more likely to die from asthma compared to other groups, and African-American women are the most likely to die in an asthma attack.

Good Care and Education Decreases Fatal Asthma

If you are at increased risk then you need to make sure that you understand the signs and symptoms of worsening asthma and monitor your symptoms regularly. Most asthma fatalities occur after days of symptoms and it is rarely a sudden event. While it occurs asthma fatalities after only minutes or hours of symptoms are uncommon.

One of the things that distinguish people who die from asthma from those who recover is knowing when to seek emergency care. Some people don't perceive the shortness of breath caused by an asthma attack. Other people ignore symptoms because they remember times when they had severe symptoms and recovered with self-care. Others are just not aware that asthma can be fatal. Finally, some people rely on short-acting rescue inhalers or have deficient family support systems.

All of these barriers are remediable with education and action taking.

What to Do If You Are at Increased Risk

All of the following may help you reduce your risk of an asthma-related death:

  • Know that you are at risk
  • Know your asthma action plan
  • Make sure you understand your asthma action plan
  • Use your asthma action plan
  • Use your peak flow meter regularly
  • Do not delay seeking emergency care if your symptoms worsen
  • Tell your asthma care provider that you are at increased risk of an asthma-related death
  • Make sure you can effectively communicate with an asthma care provider

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