REVIEW OF ASTHMATIC PATIENTS HOSPITALIZED IN PAVILION SERVICE OF NEW YORK HOSPITAL FROM 1948 TO 1963 WITH EMPHASIS ON MORTALITY RATE

Raldwin and colleagues1 reviewed records of patients admitted to The New York Hospital with a primary diagnosis of asthma from 1933 to 1948. The present study covers the period from 1948 to 1963, during which time steroids and the more extensive use of antimicrobials have been introduced into the therapeutic regimen. There were 269 patients admitted during the current 15 year period compared to 434 in the earlier 15 year study. In comparison to the earlier series, there was a shorter hospital stay for both pediatric and adult cases, but the difference was most marked with the children. There were 7 deaths in the current series (2.6 per cent) compared to 6 (1.4 per cent) in the earlier series. The increased mortality in the current series may be more apparent than real and may merely reflect a more seriously ill group of patients in the current study, steroids and antimicrobials having made it possible to manage many patients without the need for hospitalization. Detailed study of the fatal cases in the current series suggested that barbiturates and opiates contributed to fatal termination. Thirty-one patients received barbiturates, 7 of whom died; 10 received meperidine HCl (Demerol), 2 of whom died; 5 received morphine, 3 of whom died. (Some patients received 2 or more of these drugs.) Epinephrine in the presence of cardiac overloading or in combination with isoproterenol may cause death from arrhythmia. This may have been a factor in one death in this series. © 1968.