Risk factors associated with asthma exacerbations in school-age children

摘要

BackgroundAcute asthma exacerbation is one of the most frequentemergencies in childhood. Awareness of risk factorsrelated with asthma exacerbation will reduce the morbidityand the mortality of the disease. The aim of thisstudy is to investigate the factors associated with asthmaexacerbations in school-age children.MethodChildren who attended to a tertiary outpatient pediatricallergy and asthma department and diagnosed withasthma were enrolled in the study. A questionnaireincluding demographic features and parameters todetermine socioeconomic status were applied. Asthmacontrol status of patients was evaluated according toGINA criteria. Laboratory investigations including completeblood counts with differential, total IgE levels, skinprick tests and pulmonary function tests were alsoperformed.ResultsA total of 348 children (232 male (66.7%); with a medianage [interquartile range] of 8.0 [6.2-11.1] years wereincluded. 45.9% of children had aeroallergen sensitization.Asthma was controlled in 138 children (39.7%),whereas partially controlled and uncontrolled in 45(12.9%) and 98 (28.2%) patients, respectively. 67 patients(19.3%) were having an asthma exacerbation. The historyof ER admittance and asthma exacerbation in thelast year was more frequent in children with asthmaexacerbation (p <0.001 and p<0.001, respectively). Moreover,children with asthma exacerbation were less frequentlyunder regular asthma controller therapy(p<0.001). Multivariate logistic regression analysisrevealed that history of asthma exacerbation in the lastyear (Odds Ratio [Confidence Interval]) (22.47 [9.28-54.44]; p<0.001), lack of regular asthma controller therapy(3.51 [1.22-10.10]; p=0.02), lack of previous asthmadiagnosis (3.34 [1.70-6.57]; p< 0.001) and being overweight(2.25 [1.15-4.40]; p=0.018) were related withasthma exacerbation in school-age children with asthma.ConclusionAwareness of risk factors related with asthma exacerbationmay alert physicians who deal with school-age childrenwith asthma and may help prompt and rationalinterventions in order to prevent asthma exacerbations.