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Published on: August 7, 2017
Risk factors for asthma attacks and poor control in children: a prospective observational study in UK primary care
David Lo1,2, Caroline Beardsmore1, Damian Roland3,4
1Department of Respiratory Sciences, University of Leicester, Leicester, UK.
Insights
Identifying asthma attack risk factors in children is crucial. Poor symptom control and a history of attacks predict future events, while Asian ethnicity may offer protection.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Clinical Research
Background:
- Asthma affects millions of children globally, necessitating identification of factors contributing to poor control and exacerbations.
- Understanding pediatric asthma triggers is vital for effective management and prevention of severe outcomes.
Purpose of the Study:
- To determine key risk factors associated with asthma attacks and inadequate asthma control in children aged 5-16 years.
- To inform clinical practice by identifying children at higher risk for adverse asthma-related events.
Main Methods:
- A prospective observational cohort study involving 460 children with asthma in UK general practices.
- Collected baseline data on demographics, BMI, spirometry, and FeNO; tracked asthma control, medication ratio, and attacks over 6 months.
- Utilized binary multiple logistic regression to analyze predictors of poor symptom control and asthma attacks.
Main Results:
- Poor baseline symptom control predicted persistent poor control (OR 4.4).
- Higher FeNO levels (OR 1.02) and prior asthma attacks (OR 2.03) predicted future attacks.
- Asian ethnicity (OR 0.32) was linked to fewer attacks, while decreased asthma medication ratio (OR 2.99) increased attack risk.
Conclusions:
- Identified significant predictors for poor asthma control and future asthma attacks in children.
- Routine assessment of identified risk factors during asthma reviews can help pinpoint high-risk children.
- This proactive approach aims to reduce adverse asthma-related events in pediatric populations.
Objective:
To identify risk factors for asthma attacks and poor asthma control in children aged 5-16 years.
Methods:
Prospective observational cohort study of 460 children with asthma or suspected asthma from 10 UK general practices.Gender, age, ethnicity, body mass index, practice deprivation decile, spirometry and fraction of exhaled nitric oxide (FeNO) were recorded at baseline. Asthma control scores, asthma medication ratio (AMR) and the number of asthma attacks were recorded at baseline and at 6 months.The above independent variables were included in binary multiple logistic regression analyses for the dependent variables of: (1) poor symptom control and (2) asthma attacks during follow-up.
Results:
Poor symptom control at baseline predicted poor symptom control at 6 months (OR 4.4, p=0.001), while an increase in deprivation decile (less deprived) was negatively associated with poor symptom control at 6 months (OR 0.79, p=0.003). Higher FeNO levels (OR 1.02, p<0.001) and a recent history of asthma attacks (OR 2.03, p=0.02) predicted asthma attacks during follow-up. Asian ethnicity was associated with a lower OR for a future attack (OR 0.32, p=0.02).A decrease in AMR was also associated with an increased OR for future asthma attacks (OR 2.99, p=0.003) when included as an independent variable.
Conclusions:
We identified risk factors for poor symptom control and asthma attacks in children. Routine assessment of these factors should form part of the asthma review to identify children at an increased risk of adverse asthma-related events.
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