Characterization of autopsy-proven fatal asthma patients in São Paulo, Brazil / Caracterización de los pacientes fallecidos por asma certificada por autopsia en São Paulo, Brasil

ABSTRACT

Few data are available on autopsy-proven fatal asthma patients in São Paulo, Brazil. We characterized 73 asthma patients who were autopsied at the Serviço de Verificação de Óbitos da Universidade de São Paulo between 1996 and 2004. An interview with the next of kin assessed socioeconomic status, history, and treatment of asthma. There were 42 women and 31 men. Fifty-six (76.7 percent) of them were older than 34 years. Sixty-three percent were Caucasians, 77.3 percent had < 8 years of schooling, and the median income was 1.6 times the minimum wage. Twenty-two patients (30.1 percent) were smokers and 14 (19.2 percent) were ex-smokers. Only 25 (34.2 percent) patients were regularly followed by a doctor. Only 12.3 percent received inhaled steroids. Thirty-five patients (47.9 percent) had moderate-to-severe asthma. Fifty-five (75.3 percent) deaths took place outside a hospital. We conclude that this population shares characteristics of severe or poorly controlled asthma, low educational and socioeconomic levels, and lack of medical care and of inhaled steroid use.

RESUMEN

Se cuenta con poca información acerca de los pacientes fallecidos por asma certificada por autopsia en São Paulo, Brasil. Se caracterizaron 73 pacientes de asma sometidos a autopsia en el Serviço de Verificação de Óbitos da Universidade de São Paulo entre 1996 y 2004. Mediante entrevistas con sus parientes se estableció el nivel socioeconómico, los antecedentes de asma y el tratamiento seguido. Del los 73 pacientes (42 mujeres y 31 hombres), 56 (76,7 por ciento) eran mayores de 34 años; 63,0 por ciento eran caucásicos y 77,3 por ciento tenían menos de 8 años de escolaridad. La mediana de los ingresos era de 1,6 veces el salario mínimo. De los pacientes, 22 (30,1 por ciento) eran fumadores y 14 (19,2 por ciento) lo habían sido. Solamente 25 (34,2 por ciento) pacientes tenían seguimiento médico regular y solo 12,3 por ciento usaba inhaladores de esteroides; 35 (47,9 por ciento) presentaban asma moderada o intensa; 55 (75,3 por ciento) de las muertes ocurrieron fuera de los hospitales. Se concluye que esta población se caracterizaba por padecer de asma intensa o poco controlada, bajo nivel educacional y socioeconómico, carecía de atención médica y no usaba inhaladores de esteroides.