Prognosis
In the US, about 5000 deaths per year are attributed to asthma, and most of these deaths are preventable with treatment.[53] The prognosis for an exacerbation is good with prompt recognition of symptoms and access to care.
Patients with poorly controlled asthma are at risk for developing long-term airway changes over time that may become irreversible. Severe exacerbations are associated with a greater long-term decline in lung function in patients who are not taking inhaled corticosteroids (ICS) compared with those using ICS.[1] However, there is no clear evidence that ICS treatment prevents the development of persistent airflow limitation.[1]
Risk factors for asthma-related death include:[1]
A history of near-fatal asthma requiring intubation and mechanical ventilation
Hospitalization or emergency care visit for asthma in the past year
Currently using or having recently stopped oral corticosteroids
Not currently using ICS
Overuse of short-acting beta-2 agonists, especially use of one or more inhalers of albuterol (or equivalent) monthly on average, or use of nebulized short-acting beta-2 agonist
Poor adherence to ICS-containing medications and/or poor adherence to (or lack of) a written asthma action plan
A history of psychiatric disease or psychosocial problems
Food allergy (or anaphylaxis) in a patient with asthma
Comorbidities including pneumonia, diabetes, and arrhythmias.
The use of inhaled corticosteroids has been shown in several studies to decrease hospital admission and mortality rates.[96][97]
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