随着对症状的迅速识别和及时处理,急性发作的预后良好, 大多数死亡是可以预防的。 在 1995 年至 2001 年期间,美国儿童哮喘死亡率从 1.26/10 万下降到 0.78/10 万。[12]Johnston NW, Sears MR. Asthma exacerbations. 1: epidemiology. Thorax. 2006;61:722-728.http://www.ncbi.nlm.nih.gov/pubmed/16877691?tool=bestpractice.com 在1990-2000年间,英国儿童哮喘相关性死亡率维持在每年2/100万。[103]Gupta R, Strachan D. The health of children and young people. Asthma and allergic diseases. London, UK: Office for National Statistics. 2004. 与儿童哮喘相关性致死的危险因素包括对治疗的依从性差、不良的社会心理因素(在儿童这个原因主要归结于他的主要抚养人)以及不合适的短期和/或长期哮喘治疗。[104]Bergstrom SE, Boman G, Eriksson L, et al. Asthma mortality among Swedish children and young adults, a 10-year study. Respir Med. 2008;102:1335-1341.http://www.ncbi.nlm.nih.gov/pubmed/18635346?tool=bestpractice.com[105]Malmstrom K, Kaila M, Kajosaari M, et al. Fatal asthma in Finnish children and adolescents 1976-1998: validity of death certificates and a clinical description. Pediatr Pulmonol. 2007;42:210-215.http://www.ncbi.nlm.nih.gov/pubmed/17245733?tool=bestpractice.com 由于食物过敏诱发的发作更可能是致命的。[104]Bergstrom SE, Boman G, Eriksson L, et al. Asthma mortality among Swedish children and young adults, a 10-year study. Respir Med. 2008;102:1335-1341.http://www.ncbi.nlm.nih.gov/pubmed/18635346?tool=bestpractice.com[106]Roberts G, Patel N, Levi-Schaffer F, et al. Food allergy as a risk factor for life-threatening asthma in childhood: a case-controlled study. J Allergy Clin Immunol. 2003;112:168-174.http://www.ncbi.nlm.nih.gov/pubmed/12847494?tool=bestpractice.com 那些未能得到良好控制的哮喘患者,增加了将来哮喘加重以及随着时间的推移,可能发展气道重塑的的危险性,最终导致不可逆的、持续性的气道阻塞。此外,纵向研究显示,严重的哮喘发作与肺功能快速下降密切相关。[107]O'Byrne PM, Pedersen S, Lamm CJ, et al. START Investigators Group. Severe exacerbations and decline in lung function in asthma. Am J Respir Crit Care Med. 2009;179:19-24.http://www.ncbi.nlm.nih.gov/pubmed/18990678?tool=bestpractice.com