Prognosis in bronchial asthma: A study of the mortality among patients discharged during the years 1917–1936 from the Ullevål Hospital (Oslo City Hospital)

A total of 411 patients were discharged from the three medical departments at the Ulleval Hospital with the diagnoses of bronchial asthma, asthma, or asthmatic bronchitis, during the years 1917 to 1936. Of these, 66 were eliminated from the present study because of one of the following causes: (a) The patient died during his first stay in hospital (10). (b) The record could not be located (6). (c) The patient had also been hospitalized at the Ulleval Hospital for asthma prior to 1917 (12). (d) The record did not contain a description of a definite attack of dyspnea at any time (38). Of the remaining 345 patients, 327 were followed until death or until July 1, 1953. One hundred and forty-four were alive on July 1, 1953, while 183 were dead prior to that date. The actual number of deaths tor males was about twice the number expected on the basis of the Oslo mortality in the same period. For females the corresponding number was 2.5. The mortality ratio did not differ appreciably tor patients discharged in the two calendar-year periods 1917–1928 and 1929–1936. The mortality ratio for females was largest during the first five years after discharge, and thereafter dropped off. For males there was no definite trend in this direction. Patients in the age group 0–29 at discharge had a larger mortality ratio than older patients, but actual deaths were few and the result is therefore some-what uncertain. Patients with various durations of illness at time of discharge showed about the same mortality ratio when all years after discharge were considered simultaneously. Patients with short duration at time of discharge had their highest mortality ratio during the first five years after discharge, while patients with at least ten years' duration had a mortality ratio approximately equal in all years after discharge. Patients whose records contained a description of cardiovascular disease, bronchiectasis, emphysema, or other conditions of prognostic significance at time of discharge from the hospital, had a mortality ratio that was only moderately higher than patients whose records did not indicate such conditions. The prognosis for patients who developed their first attack of dyspnea on the basis of chronic bronchitis or a preceding respiratory infection did not differ significantly from the prognosis of patients with no pathologic condition prior to first attack.