A nationwide survey in Germany on fatal asthma and near-fatal asthma in children: different entities?

In adults fatal and near-fatal asthma have similar clinical characteristics . Therefore, near-fatal asthma in adults can be used as a model for fatal a sthma. A nationwide study on fatal and near-fatal asthma in children <16 yr s was performed in order to assess whether, as in adults, near-fatal asthma can be used as a model for fatal asthma. From 1996 to 1998, all paediatric hospitals and paediatric pulmonologists i n Germany were asked to report cases of fatal asthma and near-fatal asthma to a central survey unit (Erhebungseinheit fur seltene padiatrische Erkrank ungen in Deutschland (ESPED)) on a monthly basis. All reports were followed by detailed questionnaires. Sixteen fatal and 45 near-fatal asthma cases were analysed. Fatal asthma pa tients were older than near-fatal asthma patients. Respiratory tract infect ions were frequently reported only in near-fatal asthma (47 versus 0%). The proportion of cases with rapid-type onset (duration of symptoms <less than or equal to>1 h) was higher in fatal asthma (53 versus 14%). Long-term reg ular treatment with short acting beta (2)-agonists was common in both group s, but the use of concomitant inhaled corticosteroids was significantly low er in fatal asthma cases. A high proportion of poor compliance was observed in both groups. As fatal and near-fatal asthma differ significantly in important clinical a spects, analysis of near-fatal asthma might be of limited value in elucidat ing the causes of fatal asthma in children.