In an effort to determine the factors and circumstances that play critical roles in fatal asthma, a descriptive review of fatal asthma cases in Cebu Doctors Hospital in the period starting January 1, 1985 to December 31, 1990 was made. There were 6 eligible subjects with a 5:1 female-to-male ratio. All had at least 15 years history of asthma with 5 having had known previous admission for asthma in the remote or recent past. Deaths were evenly distributed throughout the day in contrast to the commonly observed asthma deaths which usually occur at night. Five of the six patients had their fatal events within 24 hours after onset of symptoms with cardiorespiratory arrest occurring before arrival in the hospital. Five of the 6 subjects had their fatal events within 24 hours after the onset of symptoms. Among these 5 subjects, 3 had their fatal events within 5 hours after the onset of symptoms. The rapidity of onset of death in our subjects may be attributable to the acuteness of onset of a severe form of asthma attack.
On the other hand, inadequate assessment of the severity of asthma may be an underlying factor accounting for the apparent suddenness of deaths in our asthmatic subjects since failure to assess severity adequately would mean withholding more effective forms of therapy. Hence it was judged that inadequate assessment of the severity of asthma attack by both the physician and the patient play a critical role in the subsequent outcome of a severe asthma attack.

Cebu Doctors' Proceedings, 1992 8 (2) pages 65-72