With prompt recognition of symptoms and access to care, the prognosis of an acute exacerbation is good. In 2018 in the US, the mortality rate from childhood asthma was 0.26 per 100,000.[139]Centers for Disease Control and Prevention. Most recent asthma data. Dec 2022 [internet publication].
https://www.cdc.gov/asthma/most_recent_data.htm
In England, during the period April 2006 to March 2013, the mortality rate among children with acute asthma as the primary reason for admission to the pediatric intensive care unit was 0.7% (15/2195).[140]Mukherjee M, Cunningham S, Bhuia MR, et al. Asthma in paediatric intensive care in England residents: observational study. Sci Rep. 2022 Jan 25;12(1):1315.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8789863
http://www.ncbi.nlm.nih.gov/pubmed/35079067?tool=bestpractice.com
Most deaths from asthma are preventable. Children at increased risk of asthma-related death should be identified and receive more frequent follow-up.[7]Global Initiative for Asthma. 2024 GINA report, global strategy for asthma management and prevention. May 2024 [Internet publication].
https://ginasthma.org/2024-report
Several comorbidities, including pneumonia, diabetes, and arrhythmias, are independently associated with an increased risk of death following hospitalization for an exacerbation of asthma.[7]Global Initiative for Asthma. 2024 GINA report, global strategy for asthma management and prevention. May 2024 [Internet publication].
https://ginasthma.org/2024-report
Exacerbations triggered by food allergy are more likely to be fatal.[141]Bergstrom SE, Boman G, Eriksson L, et al. Asthma mortality among Swedish children and young adults, a 10-year study. Respir Med. 2008 Sep;102(9):1335-41.
http://www.ncbi.nlm.nih.gov/pubmed/18635346?tool=bestpractice.com
[142]Roberts G, Patel N, Levi-Schaffer F, et al. Food allergy as a risk factor for life-threatening asthma in childhood: a case-controlled study. J Allergy Clin Immunol. 2003 Jul;112(1):168-74.
http://www.ncbi.nlm.nih.gov/pubmed/12847494?tool=bestpractice.com
Patients whose asthma is poorly controlled are at an increased risk of future exacerbations and may develop airway remodeling over time, resulting in irreversible persistent airway obstruction. Longitudinal studies have shown that episodes of severe asthma exacerbations are associated with a more rapid decline in overall lung function.[143]O'Byrne PM, Pedersen S, Lamm CJ, et al. START Investigators Group. Severe exacerbations and decline in lung function in asthma. Am J Respir Crit Care Med. 2009 Jan 1;179(1):19-24.
http://www.ncbi.nlm.nih.gov/pubmed/18990678?tool=bestpractice.com