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Published on: August 7, 2017

Predicting an asthma exacerbation in children 2 to 5 years of age

Arlene S Swern1, Carol A Tozzi, Barbara Knorr

  • 1Merck Research Laboratories, Rahway, New Jersey 07065, USA. swern_arlene@verizon.net

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|January 6, 2009
PubMed

Insights

A combination of daytime cough, wheeze, and nighttime beta2-agonist use can predict asthma exacerbations in young children. This finding aids in early detection and prevention strategies for pediatric asthma.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Clinical Pediatrics

Background:

  • Asthma exacerbations are common in young children, necessitating early identification of predictive factors.
  • Predicting exacerbations allows for timely intervention and preventative measures.

Purpose of the Study:

  • To assess if diary symptoms and beta2-agonist use preceding an exacerbation can predict future events.
  • Focus on children aged 2 to 5 years with asthma symptoms.

Main Methods:

  • Post hoc analysis of data from 689 children (2-5 years) in a 12-week study (montelukast vs. placebo).
  • Caregiver-reported data on daytime/nighttime cough, breathing difficulties, activity limitation, and beta2-agonist use were analyzed.
  • General estimating equations with specific regression structure identified exacerbation predictors.

Main Results:

  • Increased symptom scores and beta2-agonist use preceded exacerbations, but at varying rates.
  • A combination of daytime cough, wheeze, and nighttime beta2-agonist use one day prior strongly predicted exacerbations.
  • This predictive model identified 66.8% of exacerbations with a low false-positive rate of 14.2%.

Conclusions:

  • No single symptom reliably predicted imminent asthma exacerbations in children.
  • A combination of daytime cough, wheeze, and nighttime beta2-agonist use one day before an event proved to be a strong predictor.
  • This predictive combination can aid in managing pediatric asthma exacerbations.
Abstract

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