Acute severe asthma and its predictors of mortality in rural Southwestern Nigeria: a-five year retrospective observational study

Abstract

Objectives There is an observed paucity of data regarding the predictors of asthma mortality in Nigeria. This study aimed to ascertain the clinical presentations and predictors of acute severe asthma mortality in rural Southwestern Nigeria. Methods A retrospective observational study using a data form and a standardized questionnaire was used to review the 124 patients admitted at Emergency Department between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Binary logistic regression analysis was used to determine the predictors of asthma mortality and a p-value <.05 was considered statistically significant. Results A total of 124 patients were studied. The acute severe asthma mortality was 4.8% and its predictors were older age (Crude odds Ratio (COR), 14.857; 95% CI: 2.489–88.696, p < .001), Tobacco smoking (COR, 6.741; 95% CI: 1.170–38.826, p = .016), more than three co-morbidities (COR, 2.750; 95% CI: 1.147–26.454, p = 0.012), diabetes mellitus (COR, 13.750; 95% CI: 2.380–79.433, p < .001), Human Immunodeficiency virus (COR, 117.000; 95% CI: 9.257–1479.756, p < .001), ≥2 days before presentation (COR, 7.440; 95% CI: 1.288–42.980, p = .039), and Short-acting-B2-agonists overuse (COR, 7.041; 95% CI: 1.005–62.165, p = .044). Conclusion The mortality rate was 4.8% and its predictors were older age patients, tobacco smoking, multiple co-morbidities, diabetes mellitus, HIV, SP02 <90%, delay presentation, and Short-acting-B2-agonists over use, The study showed that there is high prevalence of asthma mortality in rural Southwestern Nigeria. The findings may be used to plan for asthma preventions and control programs in rural settings, and may also provide an impetus for prospective research on these outcomes.