Refractory asthma in the UK: cross-sectional findings from a UK multicentre registry
Refractory asthma in the UK: cross-sectional findings from a UK multicentre registry
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DOI：
10.1136/thx.2010.137414
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发表时间：
2010-09-01
期刊：
影响因子：
10
通讯作者：
Niven, Rob M.
中科院分区：
文献类型：
--
作者：
Heaney, Liam G.;Brightling, Chris E.;Niven, Rob M.
难治性哮喘代表了一个重要的未满足的临床需求，其中评估和治疗管理的证据基础是有限的。英国胸科学会（BTS）困难哮喘网络已经建立了一个在线国家登记处，以评估英国困难哮喘的专科服务，并促进对困难哮喘的评估和临床管理的研究。方法来自382名符合美国胸科学会难治性哮喘定义的患者的数据，他们参加了四个英国专科中心-皇家布朗普顿医院，伦敦，格伦菲尔德医院，莱斯特，南曼彻斯特大学医院和贝尔法斯特市医院，被用来比较患者的人口统计学，疾病特征和医疗利用率。结果许多人口统计学变量，包括性别，种族和吸烟率是相似的，在英国中心和其他发表的队列难治性哮喘一致。然而，多个人口统计学因素，如就业、家族史、特应性患病率、肺功能、住院率/计划外医疗访视和药物使用与已发表的数据不同，并且在英国中心之间存在显著差异。一般的线性模型与计划外的医疗访问，抢救口服类固醇和住院作为因变量都确定了一个显着的关联与临床中心，不同的协会被确定为中心时，不包括作为一个factor.Conclusion虽然有相似之处，在英国难治性哮喘患者与其他可比发表的队列一致，也有差异，这可能反映了不同的患者人群。在英国不同的专科中心也发现了重要人群特征的这些差异。合并难治性哮喘受试者的多中心数据可能会遗漏重要的差异，并可能混淆对该人群表型的尝试。
Introduction Refractory asthma represents a significant unmet clinical need where the evidence base for the assessment and therapeutic management is limited. The British Thoracic Society (BTS) Difficult Asthma Network has established an online National Registry to standardise specialist UK difficult asthma services and to facilitate research into the assessment and clinical management of difficult asthma.Methods Data from 382 well characterised patients, who fulfilled the American Thoracic Society definition for refractory asthma attending four specialist UK centres-Royal Brompton Hospital, London, Glenfield Hospital, Leicester, University Hospital of South Manchester and Belfast City Hospital-were used to compare patient demographics, disease characteristics and healthcare utilisation.Results Many demographic variables including gender, ethnicity and smoking prevalence were similar in UK centres and consistent with other published cohorts of refractory asthma. However, multiple demographic factors such as employment, family history, atopy prevalence, lung function, rates of hospital admission/unscheduled healthcare visits and medication usage were different from published data and significantly different between UK centres. General linear modelling with unscheduled healthcare visits, rescue oral steroids and hospital admissions as dependent variables all identified a significant association with clinical centre; different associations were identified when centre was not included as a factor.Conclusion Whilst there are similarities in UK patients with refractory asthma consistent with other comparable published cohorts, there are also differences, which may reflect different patient populations. These differences in important population characteristics were also identified within different UK specialist centres. Pooling multicentre data on subjects with refractory asthma may miss important differences and potentially confound attempts to phenotype this population.