Sairaalahoito astmaatikon selviytymisen kuvaajana:rekisteritutkimus sairaalahoidossa olleiden astmaatikkojen ikä- ja sukupuolijakaumasta, uusien hoitojaksojen määrästä, hoitojaksojen vuodenaikavaihtelusta lapsilla, varusmiehillä ja aikuisilla sekä kuolleisuuden vuodenaikavaihtelusta

Abstract This thesis discusses the age and sex distribution of previously hospitalised asthmatics and the number of new asthma-induced treatment periods as a proportion of all asthma-related hospital admissions. Seasonal fluctuations in treatment periods were analysed with respect to age, and seasonal fluctuations in mortality among previously hospitalised asthmatics by combining the hospital discharge register with the mortality statistics on the basis of the patients social security numbers. A total of 364,871 asthma-induced treatment periods were reported to the hospital discharge register in 1972-1992, of which 192,195 occurred in 1.1.1983-31.12.1992, and 28.6% of these were new cases. Treatment periods relative to population amounted to 2.76/1000 in 1972 and 3.43/1000 in 1992. The number of treatment periods among children was greatest at the age of 1 year, 11.2/1000 for boys and 5.5/1000 for girls, and lowest at 17 years among the boys, and 13 years among the girls. The numbers rose slowly in early adulthood (with the exception of men aged 18-22 years), reaching a new peak at 73 years of age for men, 10.3/1000, and 75 years for women, 9.5/1000, and decreasing gradually thereafter. A half of the treatment periods recorded for patients aged under 1 year or for men aged 20 years represented new cases, whereas otherwise the vast majority of the treatment periods were being readmissions. The seasonal peaks among the total of 59,624 hospital periods involving persons aged under 15 years reported to the discharge register in 1972-1992 occurred in May and October, and the lowest figures in January and July. Conscripts aged 18-22 years experienced 4894 asthma-induced treatment periods in 1982-1992, representing incidence rates of 8.5/1000 in 1982 and 27.7/1000 in 1992. The figure was highest in the month in which the conscripts entered service and the month following that. A total of 81,243 asthma-induced treatment periods were recorded for persons aged over 24 years in 1987-1992, the figures being highest in January-May, 18.2% above the monthly trend in January, and lowest in July, 26.1% below the monthly trend. 7622 of the asthmatics first admitted in 1977-1992 died at an age of over 24 years in 1987-1993, mortality being highest in December and January and lowest in August. Obstructive pulmonary diseases were the primary cause of death for 1283 persons, including 489 who died of asthma itself. Apart from children and men aged 18-22 years, asthma gives rise to a large number of treatment periods among the middle-aged and the elderly. Measures should be taken to diagnose it at an early stage in these groups and to intensify the treatment provided. In addition, the factors provoking asthma during military service should be minimised and preventive measures enhanced in the case of children in May and September. As far as adults are concerned, asthma-related hospitalisation may involve a greater fatality risk in winter, so that aggravations occurring in winter should be treated with particular care