EXTREME HYPERCAPNIA IS NOT A LONG-TERM PROGNOSTIC FACTOR AFTER NEAR-FATAL ASTHMA - A 12-YEAR FOLLOW-UP-STUDY

Question of the study: Some patients experiencing near-fatal asthma pr esent with extreme hypercapnia (PaCO2 greater than or equal to 100 mm Hg), whereas other do not. The influence of this factor on short- and long-term outcome and quality of life in these patients is still unkno wn. Patients and methods: A series of 39 consecutive patients who had had an episode of near-fatal asthma between 1978 and 1992 were followe d up. Long-term outcome and quality of life of the 12 patients who had experienced extreme hypercapnia were compared with those of the 27 pa tients who had not. Results: Four patients died, but only 1 from asthm a. Three patients were lost to follow-up. The remaining 32 patients ha d a median observation period of 12.7 years. The hypercapnic patients did not significantly differ from the others in past asthma history, s ubsequent hospitalizations, medication needs, pulmonary function tests , quality of life and impairment/disability. In the event of subsequen t near-fatal asthma attacks, they tended to present with hypercapnia l evels similar to those observed during the first episode. Discussion: Extreme hypercapnia in near-fatal asthma tended to recur, but is not a n aggravating long-term prognostic factor. Targeted surveillance of th ese high-risk patients should make it possible to reduce relapses and death rates from asthma.