Prognosis

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] 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]

Most deaths from asthma are preventable. Children at increased risk of asthma-related death should be identified and receive more frequent follow-up.[7] Several comorbidities, including pneumonia, diabetes, and arrhythmias, are independently associated with an increased risk of death following hospitalization for an exacerbation of asthma.[7] Exacerbations triggered by food allergy are more likely to be fatal.[141][142]

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]

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