喘息死および致死的高度発作救命例の比較検討  [in Japanese] A COMPARISON OF ASTHMA DEATHS AND NEAR-FATAL ASTHMA ATTACKS  [in Japanese]

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Abstract

喘息死および致死的高度発作救命例(以下, 救命例)についてアンケート調査により比較検討した. 喘息死は67例, 救命例は80例である. 喘息死は51.9歳と救命例の44.3歳より8歳高齢であるが, 病型, 重症度, 過去の高度発作歴など差を認めなかった. 高度発作の起こり方は急速型は喘息死で救命例より多く, 不安定急変型は喘息死で救命例より少なかった. 喘息死は在宅〜来院途中の死亡が76.2%を占めていた. 高度発作をおこした因子では受診の遅れが喘息死で救命例より有意に多く, また不適当な治療, 仕事・勉強の優先などがみられた. 死亡例と救命例の致死的高度発作前の状況では両群とも酸素吸入, 救急車の利用, 夜間外来受診, 入院歴などが目立つが差を認めない. 以上のごとく喘息死と救命例は, 基本的には同一のハイリスクグループに属し, 受診の遅れによりDOAになる前に救急施設に到着するかどうかの差であった. また喘息死の解明には救命例の分析が有力であることが判明した.

This study compares the characteristics of fatal asthma patients and those of near-fatal asthma patients who had experienced severe life threatening attacks. Data from 67 fatal asthma patients and 80 near-fatal asthma patients were analyzed. The mean age of fatal asthma cases were older than near-fatal asthma cases, 51.9 yrs and 44.3 yrs, respectively. Similarities of the two cases were seen in sex, type of asthma and severity of asthma. The experiences of previous life-thretening asthma did not differ in both groups (43.3% of fatal vs 40.0% of near-fatal). From the viewpoint of type of development of severe exacerbation, rapid exacerbation was more frequent in fatal cases than near-fatal cases, but acute exacerbation after unstable asthma was more in near-fatal asthma. Seventy-six percent of all asthma deaths occured at home or on the way to the emergency department. The rate of delay of receiving medical care was significantly higher in fatal cases (72%) than near-fatal cases (26%). There was no significant difference in the frequency of medical management before fatal or near-fatal episode such as oxygen therapy, mechanical ventilation. Use of ambullance, visiting emergency department, previous hospitalization between the two groups. The profile of fatal cases was almost same to that of near-fatal cases except delay of receiving medical care. In conclusion, the analysis of near-fatal cases was very important to make clear the causes of asthma death.

Journal

  • Japanese Journal of Allergology

    Japanese Journal of Allergology 45(12), 1262-1269, 1996

    Japanese Society of Allergology

References:  21

Cited by:  1

Codes

  • NII Article ID (NAID)
    110002419156
  • NII NACSIS-CAT ID (NCID)
    AN00012583
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0021-4884
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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