R~SUMELa fr4quence de l'asthme grave peut 8tre appr6cide au travers des statistiques de mortalit4, d'hospitalisation et des enqu4tes 6pid6miologiques. Les facteurs de risque d'asthme grave, souvent intriquds, concernent le patient lui-mSme (age, niveau socio-6conomique, d6ni de la maladie, d4pression, gravit6 propre de la maladie), son environnement (6v4nements de la vie, allerghnes, infections virales et microbiennes, pollution atmosph6rique, tabagisme) et le syst~me de sant6 (acc~s aux soins, qualit6 de la prise en charge m4dicale). La responsabi-lit6 de la plupart de ces facteurs n'est connue qu'fi partir d'observations isol6es ou de courtes s6ries. Leur meilleure connaissance pourrait permettre une meilleure prise en charge l'6chelon individuel.MOTS-CLt~S : Asthme -l~pid4miologie.
SUMMARYEpidemiology of severe asthma. -Prevalence of severe acute asthma can be evaluated through mortality statistics, hospitalization rates and epidemiological studies. Risk factors include personnal characteristics (age, socio-economic status, disease denial, depression, medical features associated with increased severity), environment factors as life events and exposure to specific (allergens) and as non-specific factors (viral or microbial infections, passive smoking, air polluants) and the health care system (care delivery, quality of medical management), Such factors are inter-related. Their knowledge should allow a better management leading to a lower incidence of severe acute asthma attacks.KEY-WORDS : Asthma -Epidemiology.
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