Recent asthma exacerbations: A key predictor of future exacerbations
Recent asthma exacerbations: A key predictor of future exacerbations
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DOI：
10.1016/j.rmed.2006.07.005
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发表时间：
2007-03-01
影响因子：
4.3
通讯作者：
Wenzel, Sally E.
中科院分区：
文献类型：
--
作者：
Miller, Mary K.;Lee, June H.;Wenzel, Sally E.
目的：本分析的目的是调查近期经历严重哮喘发作的严重或难治性哮喘患者未来哮喘发作的风险是否增加。方法：我们对来自哮喘流行病学和自然史：结局和治疗方案研究的2780例年龄为12岁的患者进行了1.5年的前瞻性分析。严重恶化被定义为在研究访问前3个月内与哮喘相关的急诊就诊或住院一晚；第二次分析评估了先前的类固醇爆发作为独立的预测因素和结果。通过统计调整人口统计学和临床因素，以及哮喘严重程度和哮喘控制来评估潜在的混杂因素。结果：与没有近期严重加重的患者相比，近期加重的患者未来加重的风险增加（优势比= 6.33;95% CI 4.57, 8.76），即使在调整了人口统计学和临床因素（优势比= 3.77;95% CI 2.62, 5.43）、哮喘严重程度（医生评估：优势比= 5.62;95% CI 4.03, 7.83）、国家哮喘教育和预防计划(优势比= 5.07；95%可信区间3.62,7.11)、全球哮喘倡议（优势比= 5.32；95%可信区间3.80,7.47）和哮喘控制（优势比= 3.90；95%可信区间2.77,5.50）。结论：该分析表明，近期严重哮喘加重是预测未来加重的一个强有力的独立因素，因此，应将其作为严重或难治性哮喘患者临床评估的一部分。(c) 2006年Elsevier Ltd出版
Objective: The objective of this analysis was to investigate whether patients with severe or difficult-to-treat asthma who experienced recent severe asthma exacerbations are at increased risk of future asthma exacerbations.Methods: We conducted a 1.5-year prospective analysis of 2780 patients >= 12 years of age from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study. Severe exacerbations were defined as either an asthma-related emergency department visit or night of hospitalization in the 3 months prior to study visit; a secondary analysis assessed prior steroid bursts as an independent predictor and outcome. Potential confounding was assessed by statistical adjustment for demographic and clinical factors, as well as asthma severity and asthma control.Results: Compared with patients without a recent severe exacerbation, patients with a recent exacerbation were at increased risk of future exacerbation (odds ratio = 6.33; 95% CI 4.57, 8.76), even after adjustment for demographics and clinical factors (odds ratio = 3.77; 95% CI 2.62, 5.43), asthma severity (physician-assessed: odds ratio = 5.62; 95% CI 4.03, 7.83), National Asthma Education and Prevention Program (odds ratio = 5.07; 95% Cl 3.62, 7.11), Global Initiative for Asthma (odds ratio = 5.32; 95% CI 3.80, 7.47), and asthma control (odds ratio = 3.90; 95% CI 2.77, 5.50).Conclusion: This analysis suggests that recent severe asthma exacerbations are a strong independent factor predicting future exacerbations and, as such, should be considered as part of the clinical assessment of patients with severe or difficult-to-treat asthma. (c) 2006 Published by Elsevier Ltd.