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Published on: August 7, 2017
Factors Associated With Asthma Control in 121 Preschool Children
P Leiria-Pinto1,2, P Carreiro-Martins1,2, I Peralta1
1Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal.
Insights
Asthma flare-ups, rhinitis, and lung function changes predict uncontrolled asthma in preschoolers. These findings help identify children needing closer asthma management and monitoring.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Research
Background:
- Asthma control in preschool children is poorly understood.
- Risk factors for uncontrolled asthma in this age group require clarification.
Purpose of the Study:
- To investigate associations between clinical/functional parameters and uncontrolled asthma in preschoolers.
- To identify predictors of poor asthma control in young children.
Main Methods:
- Recruited preschool children (3-5 years) with asthma and healthy controls.
- Utilized questionnaires for risk factors and Global INitiative for Asthma criteria for control.
- Assessed lung function and bronchial reversibility via impulse oscillometry and spirometry.
Main Results:
- 50% of children with asthma had uncontrolled disease.
- Increased risk factors included >3 flare-ups, moderate-to-severe rhinitis, and lung function variability (FVC, FEV1).
- Models incorporating lung function variability showed high discriminative ability (AUC 0.81-0.82).
Conclusions:
- Clinical and functional parameters are linked to uncontrolled asthma in preschoolers.
- Further research is warranted to validate impulse oscillometry's role in asthma management.
Background And Objectives:
Data on risk factors for uncontrolled asthma in preschool children are controversial. Objective: This study aims to explore the association between clinical and functional parameters and the lack of asthma control in preschool children.
Methods:
Children aged 3-5 years with asthma and healthy controls were recruited. A questionnaire was used to identify potential risk factors for uncontrolled asthma, as defined by the Global INitiative for Asthma criteria. Lung function and bronchial reversibility were evaluated through impulse oscillometry and spirometry. Adjusted odds ratios were estimated based on multivariable generalized additive regression models. The discriminative ability of the models was measured by the area under the receiver operating characteristic curve (AUC).
Results:
The study population comprised 121 children (107 with asthma and 14 healthy controls). Fifty-three patients (50%) had uncontrolled asthma. After adjustment, the variables associated with an increased risk of lack of control were as follows: "More than 3 flare-ups in the last 12 months", "Moderate to severe rhinitis", and "Relative variation in postbronchodilator FVC and FEV1". The AUC of the final models that included variation in FVC or FEV1 were 0.82 and 0.81, respectively. The R5-20, R5-20%, and AX z-score values of the healthy group were lower than those of children with asthma.
Conclusion:
In preschool children, clinical and functional parameters are associated with uncontrolled asthma. More studies are needed to confirm the usefulness of impulse oscillometry.
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