BACKGROUND: Identification of patients at risk for asthma exacerbations can assist physicians in addressing disease management and improve asthma-related health outcomes. OBJECTIVE: We sought to evaluate whether level of impairment, as defined by the 2007 asthma guidelines, predicts risk for future asthma exacerbations. METHODS: The study included children aged 6 to 11 years (n = 82) and adolescent/adult patients aged 12 years and older (n = 725) from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study with data representing all components of the impairment domain of the asthma guidelines at baseline, month 12, and month 24. Patients were categorized into 2 cohorts: (1) consistently very poorly controlled (VPC) asthma from baseline through 2 years of follow-up and (2) improved from VPC asthma at baseline (including patients who improved to not well-controlled or well-controlled asthma), with improvement maintained through 2 years of follow-up. Odds ratios (ORs) and 95% CIs for risk of asthma exacerbations at month 30 were generated by using multivariable logistic regression by age group. RESULTS: After adjustment, children with consistently VPC asthma over the 2-year period demonstrated a 6-fold increased risk of hospitalization, emergency department visit, or corticosteroid burst (OR, 6.4; 95% CI, 1.2-34.5) compared with the improved group. Adolescent/adult patients with consistently VPC asthma were more likely to have a corticosteroid burst (OR, 2.8; 95% CI, 1.7-4.8) or have a hospitalization, emergency department visit, or corticosteroid burst (OR, 3.2; 95% CI, 1.9-5.3). CONCLUSIONS: Consistently VPC asthma, as defined by the impairment domain of the 2007 asthma guidelines, is strongly predictive of future asthma exacerbations.
BACKGROUND: Identification of patients at risk for asthma exacerbations can assist physicians in addressing disease management and improve asthma-related health outcomes. OBJECTIVE: We sought to evaluate whether level of impairment, as defined by the 2007 asthma guidelines, predicts risk for future asthma exacerbations. METHODS: The study included children aged 6 to 11 years (n = 82) and adolescent/adult patients aged 12 years and older (n = 725) from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study with data representing all components of the impairment domain of the asthma guidelines at baseline, month 12, and month 24. Patients were categorized into 2 cohorts: (1) consistently very poorly controlled (VPC) asthma from baseline through 2 years of follow-up and (2) improved from VPC asthma at baseline (including patients who improved to not well-controlled or well-controlled asthma), with improvement maintained through 2 years of follow-up. Odds ratios (ORs) and 95% CIs for risk of asthma exacerbations at month 30 were generated by using multivariable logistic regression by age group. RESULTS: After adjustment, children with consistently VPC asthma over the 2-year period demonstrated a 6-fold increased risk of hospitalization, emergency department visit, or corticosteroid burst (OR, 6.4; 95% CI, 1.2-34.5) compared with the improved group. Adolescent/adult patients with consistently VPC asthma were more likely to have a corticosteroid burst (OR, 2.8; 95% CI, 1.7-4.8) or have a hospitalization, emergency department visit, or corticosteroid burst (OR, 3.2; 95% CI, 1.9-5.3). CONCLUSIONS: Consistently VPC asthma, as defined by the impairment domain of the 2007 asthma guidelines, is strongly predictive of future asthma exacerbations.
Authors: Arlene M Butz; Melissa Bellin; Mona Tsoukleris; Shawna S Mudd; Joan Kub; Jean Ogborn; Tricia Morphew; Cassia Lewis-Land; Mary Elizabeth Bollinger Journal: J Allergy Clin Immunol Pract Date: 2017-09-22
Authors: Wilson Quezada; Eun Soo Kwak; Joan Reibman; Linda Rogers; John Mastronarde; William G Teague; Christine Wei; Janet T Holbrook; Emily DiMango Journal: Ann Allergy Asthma Immunol Date: 2015-12-19 Impact factor: 6.347
Authors: W Gerald Teague; Brenda R Phillips; John V Fahy; Sally E Wenzel; Anne M Fitzpatrick; Wendy C Moore; Annette T Hastie; Eugene R Bleecker; Deborah A Meyers; Stephen P Peters; Mario Castro; Andrea M Coverstone; Leonard B Bacharier; Ngoc P Ly; Michael C Peters; Loren C Denlinger; Sima Ramratnam; Ronald L Sorkness; Benjamin M Gaston; Serpil C Erzurum; Suzy A A Comhair; Ross E Myers; Joe Zein; Mark D DeBoer; Anne-Marie Irani; Elliot Israel; Bruce Levy; Juan Carlos Cardet; Wanda Phipatanakul; Jonathan M Gaffin; Fernando Holguin; Merritt L Fajt; Shean J Aujla; David T Mauger; Nizar N Jarjour Journal: J Allergy Clin Immunol Pract Date: 2017-08-31
Authors: Flory L Nkoy; Bryan L Stone; Bernhard A Fassl; Derek A Uchida; Karmella Koopmeiners; Sarah Halbern; Eun H Kim; Allison Wilcox; Jian Ying; Tom H Greene; David M Mosen; Michael N Schatz; Christopher G Maloney Journal: Pediatrics Date: 2013-11-11 Impact factor: 7.124
Authors: Diana C Doeing; Amit K Mahajan; Steven R White; Edward T Naureckas; Jerry A Krishnan; Douglas K Hogarth Journal: J Asthma Date: 2012-12-20 Impact factor: 2.515
Authors: Rebecca E Slager; Gregory A Hawkins; Xingnan Li; Dirkje S Postma; Deborah A Meyers; Eugene R Bleecker Journal: Clin Chest Med Date: 2012-07-07 Impact factor: 2.878