An Audit of Asthma Deaths at Beaumont Hospital, Dublin

Title: An Audit of Asthma Deaths at Beaumont Hospital, Dublin
Author(s): A O'Connor C Hayes D Long RW Costello DM Ryan
Institution: Beaumont Hospital
Poster: Click to view poster
Category: Asthma and COPD
Abstract: Asthma is common, affecting 1 in 13 people in Ireland (1). 60-70% is uncontrolled, with an associated increased risk for death (2). In Beaumont Hospital (BH), we recently audited asthma standards of care (SOC) for ward and ICU admissions. We now proceed to an audit of asthma deaths.

Asthma deaths occurring between January 2010 and February 2020 were identified using the Hospital In-Patient Enquiry (HIPE) system. An audit pro-forma was designed evaluating asthma SOC, against National Clinical Effectiveness Committee Guidelines (2015).

HIPE confirmed approximately 80 asthma admissions per year (3% ICU) to BH and four in-patient asthma deaths during 2010-2020 (0.5%). Median age 63 (34-86) years, 3/4 (75%) female, 3/4 (75%) non-smokers, 1/4 (25%) prior ICU admission, 3/4 (75%) multiple co-morbidities, 1/4 (25%) intubated and died in ICU. Median time to death 3 (2-13) days. Disappointingly, there was no peak flow (PEFR) monitoring performed (100%) and steroid dosing was inappropriate (75% exceeded, 25% below guidelines) (see Table).

Asthma death following admission to Beaumont Hospital is rare. Asthma deterioration was early, similar to our ICU cohort. There were no differences in standard of care between patients who survived or died following asthma exacerbation.