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Contribution of aspirin-intolerant asthma to near fatal asthma based on a questionnaire survey in Niigata Prefecture, Japan

Authors

  • Fumitoshi YOSHIMINE,

    1. Niigata Asthma Treatment Study Group,
    2. Department of Internal Medicine, Niigata Prefectural Tsugawa Hospital,
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  • Takashi HASEGAWA,

    Corresponding author
    1. Niigata Asthma Treatment Study Group,
    2. Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences and
      Takashi Hasegawa, Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan. Email: htaka@med.niigata-u.ac.jp
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  • Eiichi SUZUKI,

    1. Niigata Asthma Treatment Study Group,
    2. Division of General Medicine, Niigata University Hospital, Niigata, Japan
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  • Masaki TERADA,

    1. Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences and
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  • Toshiyuki KOYA,

    1. Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences and
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  • Ariyoshi KONDOH,

    1. Niigata Asthma Treatment Study Group,
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  • Masaaki ARAKAWA,

    1. Niigata Asthma Treatment Study Group,
    2. Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences and
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  • Hirohisa YOSHIZAWA,

    1. Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences and
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  • Fumitake GEJYO

    1. Niigata Asthma Treatment Study Group,
    2. Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences and
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Takashi Hasegawa, Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan. Email: htaka@med.niigata-u.ac.jp

Abstract

Objective:  Prevention of deaths due to asthma is one of the most important issues in asthma management. However, there are few epidemiological studies of asthma deaths in Japan.

Methodology:  Over an 8-week period in Niigata Prefecture, Japan, a questionnaire on asthma control and emergency episodes was administered to adult asthmatic patients. A questionnaire was also given to the patients’ physicians to obtain further clinical information. Patients who became unconscious during episodes of asthma, or who required intubation and ventilation, were allocated to a near-fatal asthma group (NFA). Patients who did not fulfill these criteria were allocated to the non-NFA group. The NFA group was divided into two subgroups, based on the date of their last NFA episode (old NFA ≥ 5 years and recent NFA < 4 years).

Results:  Characteristic features of the NFA group included severe disease (23.1%vs 7.6%) with more aggressive patient management, including inhaled corticosteroid use (84.3%vs 72.0%). Multiple regression analysis confirmed that aspirin-intolerant asthma (AIA) was strongly associated with NFA. There was no difference in the incidence of AIA between the recent and old NFA patients. This suggests the incidence of AIA in NFA did not improve over time.

Conclusions:  A history of AIA may be a useful indicator of potential NFA and allow preventative methods to be introduced. It is therefore important to obtain a history of AIA and to be aware of the risk of NSAID administration to these patients.

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