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Mortality in asthmatics over 15 yrs: a dynamic cohort study from 1983–1998

¹ Darlington Memorial Hospital National Health Service Trust, Darlington, ² University of Newcastle upon Tyne, Newcastle and ³ University of Edinburgh, Edinburgh, UK

CORRESPONDENCE: C.K. Connolly, Aldbrough House, Aldbrough St John, Richmond, North Yorkshire, DL11 7TP, UK. Fax: 44 1325374759. E-mail: ck-r.connolly@medix-uk.com

Keywords: asthma, best function, cohort study, forced expiratory volume in one second, mortality, social class

Received: January 5, 2001
Accepted October 7, 2001

This study was supported at various phases by Glaxo Wellcome PLC (Duncan Flockhart Ltd and Allen and Hanburys Ltd), the National Asthma Campaign and Breath North (in association with the British Lung Foundation) and local research funds.

The Darlington and Northallerton long-term asthma study observes outcome in asthmatics in the light of potential explanatory variables recorded prospectively. This paper reports changes in mortality during the study, and assesses the relevant risk factors.

All asthmatics attending secondary care were recruited at 5-yr intervals from 1983 and reviewed 5 yrs later. Demographic and functional variables, including a formal estimate of best function were recorded prospectively.

The dynamic cohort comprised 1,148 asthmatics with 95% follow-up, enabling 612 observations in the period 1983/1988, 774 in 1988/93 and 823 in 1993/98, with 101, 111 and 100 deaths respectively. Principal risk factors for mortality were lower social class and best forced vital capacity. Mortality relative to 1983 halved by 1993/98 and was reduced against the Darlington population, despite an entry forced expiratory volume in one second of 84.7%. There was no change in predictive value of risk factors during the study period, or with date of entry.

This study demonstrates a consistent reduction in mortality, which was not entirely a survivor effect, but may be associated with changes in management. By 1993/98 mortality approximated to that of the local reference population despite a lower than predicted forced expiratory volume in one second.

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