PRESCRIBED FENOTEROL AND DEATH FROM ASTHMA IN NEW-ZEALAND, 1981-7 - A FURTHER CASE-CONTROL STUDY
PRESCRIBED FENOTEROL AND DEATH FROM ASTHMA IN NEW-ZEALAND, 1981-7 - A FURTHER CASE-CONTROL STUDY
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DOI：
10.1136/thx.46.2.105
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发表时间：
1991-02-01
期刊：
影响因子：
10
通讯作者：
BEASLEY, R
中科院分区：
文献类型：
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作者：
GRAINGER, J;WOODMAN, K;BEASLEY, R
通过研究1981- 1987年期间因哮喘死亡的112例5-45岁患者（在死亡前12个月内因哮喘住院），进一步调查了吸入非诺特罗与哮喘死亡之间的关系。选择两个年龄相匹配的对照组。对照组A包括427名患者，这些患者在相应的死亡发生的日历年内因哮喘住院，并且在过去12个月内也曾因哮喘住院。对照组B包括448名在相应病例入院的日历年内因哮喘住院的患者。以A组为对照（既往研究采用的方法）吸入非诺特罗的比值比为2.11(95%可信区间（CI） 1.37 ~ 3.23, p < 0.01)，以B组为对照（既往研究批评者推荐的方法）吸入非诺特罗的比值比为2.66 （95% CI 1.74 ~ 4.06, p < 0.01）。当使用对照组B时，慢性哮喘严重程度的标志物与哮喘死亡相关，而当使用对照组A时则无关（这表明这些标志物与使用对照组A时间接匹配）。我们还收集了关于急性哮喘严重程度和精神药物处方的各种标记的信息，但发现这些都不是重要的混杂因素。这些发现解决了先前对这一问题的病例对照研究的主要批评，并为吸入非诺特罗增加严重哮喘患者死亡风险的假设提供了支持。
The association between inhaled fenoterol and death from asthma has been investigated further by studying 112 asthma deaths (cases) during 1981-7 in patients aged 5-45 years who had been admitted to a major hospital for asthma during the 12 months before death. Two age matched control groups were chosen. Control group A comprised 427 patients who had been admitted to hospital for asthma during the calendar year that the corresponding death occurred and who had also had a previous admission for asthma in the previous 12 months. Control group B comprised 448 patients admitted to hospital for asthma during the calendar year in which the admission of the corresponding case occurred. The inhaled fenoterol odds ratio was 2.11 (95% confidence interval (CI) 1.37-3.23, p < 0.01) when group A was used as the control (the approach used in previous studies), and 2.66 (95% CI 1.74-4.06, p < 0.01) with group B as the control (the approach recommended by critics of previous studies). Markers of chronic asthma severity were associated with asthma death when control group B was used, but not when control group A was used (which indicates that these markers were indirectly matched for when control group A was used). Information was also collected on various markers of acute asthma severity and prescription of psychotropic drugs, but it was found that these were not important confounders. These findings address the major criticisms of previous case-control studies of this issue, and add support to the hypothesis that inhaled fenoterol increases the risk of death in patients with severe asthma.