Publication:
Predictive factors for moderate or severe exacerbations in asthma patients receiving outpatient care.

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Date

2017-05-02

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Gutiérrez, Francisco Javier Álvarez
Galván, Marta Ferrer
Gallardo, Juan Francisco Medina
Mancera, Marta Barrera
Romero, Beatriz Romero
Falcón, Auxiliadora Romero

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Asthma exacerbations are important events that affect disease control, but predictive factors for severe or moderate exacerbations are not known. The objective was to study the predictive factors for moderate (ME) and severe (SE) exacerbations in asthma patients receiving outpatient care. Patients aged > 12 years with asthma were included in the study and followed-up at 4-monthly intervals over a 12-month period. Clinical (severity, level of control, asthma control test [ACT]), atopic, functional, inflammatory, SE and ME parameters were recorded. Univariate analysis was used to compare data from patients presenting at least 1 SE or ME during the follow-up period vs no exacerbations. Statistically significant (p  12 years with asthma were included in the study and followed-up at 4-monthly intervals over a 12-month period. Clinical (severity, level of control, asthma control test [ACT]), atopic, functional, inflammatory, SE and ME parameters were recorded. Univariate analysis was used to compare data from patients presenting at least 1 SE or ME during the follow-up period vs no exacerbations. Statistically significant (p  A total of 330 patients completed the study, most of whom were atopic (76%), women (nearly 70%), with moderate and mild persistent asthma (>80%). Twenty-seven patients (8%) had a SE and 183 had a ME (58.5%) during follow-up. In the case of SEs, the only predictive factor identified in the multiple analysis was previous SE (baseline visit OR 4.218 95% CI 1.53-11.58, 4-month follow-up OR 6.88 95% CI 2.018-23.51) and inhalation technique (OR 3.572 95% CI 1.324-9.638). In the case of MEs, the only predictive factor found in the multiple analysis were previous ME (baseline visit OR 2.90 95% CI 1.54-5.48, 4-month follow- up OR 1.702 95% CI 1.146-2.529). The primary predictive factor for SE or ME is prior SE or ME, respectively. SEs seem to constitute a specific patient "phenotype", in which the sole predictive factor is prior SEs.

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MeSH Terms

Adult
Ambulatory Care
Anti-Asthmatic Agents
Asthma
Disease Progression
Female
Follow-Up Studies
Humans
Logistic Models
Male
Middle Aged
Prospective Studies
Severity of Illness Index
Spain
Young Adult

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Keywords

Asthma control test, Asthma management, Atopic, Disease control, Functional and inflammatory parameters, Predictive factors for exacerbations

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