Seasonal risk factors for asthma exacerbations among inner-city children.
Seasonal risk factors for asthma exacerbations among inner-city children.
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DOI：
10.1016/j.jaci.2014.12.1942
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发表时间：
2015-06
期刊：
影响因子：
--
通讯作者：
Busse WW
中科院分区：
文献类型：
--
作者：
Teach SJ;Gergen PJ;Szefler SJ;Mitchell HE;Calatroni A;Wildfire J;Bloomberg GR;Kercsmar CM;Liu AH;Makhija MM;Matsui E;Morgan W;O'Connor G;Busse WW
尽管采取了最佳的医疗管理，但即使在儿童和青少年中，哮喘恶化仍然很常见。对病情加重的宿主危险因素的识别并不完整，特别是对于季节性发作。定义哮喘发作季节特有的宿主危险因素。这是对 6-20 岁患者的回顾性分析，这些患者包括哮喘控制评估试验和内城哮喘抗 IgE 治疗试验的对照组。构建单变量和多变量模型以确定患者人口统计和历史因素、过敏致敏、呼出一氧化氮分数、肺活量测量、哮喘控制和治疗要求是否与季节性恶化相关。该分析包括 400 名患者（54.5% 为男性；59.0% 为非洲裔美国人；中位年龄 13 岁）。在观察期间，37.5% 的参与者出现病情加重，并且在秋季最常见（28.8% 的参与者）。在单变量分析中，肺功能受损与所有季节的病情加重几率均显着相关，除春季外，所有季节的前一季节病情加重也是如此。在多变量分析中，上一季节的病情加重是秋季和冬季最强的预测因素，而吸入皮质类固醇的较高需求是春季和夏季最强的预测因素。多变量模型对跌倒病情加重具有最佳预测能力（方差为 30.5%）。在一大群患有哮喘的内城区儿童中，患者病情恶化的危险因素因季节而异。因此，个体患者信息可能有助于制定预防这些季节性事件的策略。尽管采取了适当的治疗，内城区的儿童仍然面临哮喘恶化的风险。由于它们的风险因素因季节而异，因此预防策略也可能需要不同。内城区儿童哮喘发作的危险因素因季节而异。根据历史和临床变量的汇编，跌倒加重是最常见和最可预测的。
Exacerbations of asthma remain common even in children and adolescents despite optimal medical management. Identification of host risk factors for exacerbations is incomplete, particularly for seasonal episodes. Define host risk factors for asthma exacerbations unique to their season of occurrence. This is a retrospective analysis of patients aged 6-20 years who comprised the control groups of the Asthma Control Evaluation trial and the Inner City Anti-IgE Therapy for Asthma trial. Univariate and multivariate models were constructed to determine if patient demographic and historical factors, allergic sensitization, fractional exhaled nitric oxide, spirometric measurements, asthma control, and treatment requirements were associated with seasonal exacerbations. The analysis included 400 patients (54.5% male; 59.0% African American; median age 13 years). Exacerbations occurred in 37.5% of participants over the periods of observation and were most common in the fall (28.8% of participants). In univariate analysis, impaired pulmonary function was significantly associated with greater odds of exacerbations for all seasons, as was an exacerbation in the previous season for all seasons except spring. In multivariate analysis, exacerbation in the previous season was the strongest predictor in fall and winter while a higher requirement for inhaled corticosteroids was the strongest predictor in spring and summer. The multivariate models had the best predictive power for fall exacerbations (30.5% variance attributed). Among a large cohort of inner city children with asthma, patient risk factors for exacerbations vary by season. Thus, individual patient information may be beneficial in strategies to prevent these seasonal events. Inner city children remain at risk for asthma exacerbations despite appropriate therapy. Because their risk factors vary by season, strategies to prevent them may need to differ as well. Risk factors for asthma exacerbations among inner city children varied by season. Fall exacerbations were the most common and the most predictable based on a compilation of historical and clinical variables.
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DOI：
10.1016/j.jaip.2013.07.009
发表时间：
2013-11-01
影响因子：
9.4
作者：
Schatz, Michael;Zeiger, Robert S.;Camargo, Carlos A., Jr.
通讯作者：
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影响因子：
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作者：
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DOI：
10.1016/j.jaci.2006.08.041
发表时间：
2007-03
期刊：
The Journal of allergy and clinical immunology
影响因子：
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作者：
Khetsuriani N;Kazerouni NN;Erdman DD;Lu X;Redd SC;Anderson LJ;Teague WG
通讯作者：
Teague WG