Related Experiment Video
Updated: May 25, 2025
Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
Association of delayed asthma diagnosis with asthma exacerbations in children
Chung-Il Wi1,2, Euijung Ryu2,3, Katherine S King2,4
1Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn.
Insights
Delayed diagnosis of childhood asthma increases the risk of asthma exacerbations (AEs). Timely diagnosis (TD) is crucial for managing pediatric asthma and preventing AEs.
Area of Science:
- Pediatric Pulmonology
- Clinical Epidemiology
- Health Outcomes Research
Background:
- A significant time lag exists between symptom onset and diagnosis in childhood asthma.
- The clinical impact of this diagnostic delay on pediatric asthma outcomes remains incompletely understood.
Purpose of the Study:
- To investigate the association between delayed diagnosis of asthma and the occurrence of asthma exacerbations in children.
- To compare asthma exacerbation risk between children with delayed diagnosis and those with timely diagnosis.
Main Methods:
- Utilized Mayo Clinic birth cohort data and electronic health records.
- Defined delayed diagnosis (DD) as diagnosis >30 days from symptom onset, contrasted with timely diagnosis (TD) within 30 days.
- Employed a Cox proportional hazard model to assess the risk of asthma exacerbations, adjusting for covariates.
Main Results:
- Among 537 matched pairs, children with DD showed a significantly increased risk of asthma exacerbations (adjusted hazard ratio: 1.53; P < .001).
- The median follow-up was 9.3 years, with 344 children in the DD group and 253 in the TD group experiencing at least one exacerbation.
Conclusions:
- Delayed diagnosis of childhood asthma is linked to a higher risk of asthma exacerbations.
- Prioritizing timely diagnosis is essential for effective childhood asthma management and improving patient outcomes.
Background:
There is a significant delay between symptom onset and diagnosis of childhood asthma, but the impact of this delay on asthma outcomes has not been well understood.
Objectives:
We sought to study the association of delayed diagnosis of asthma with asthma exacerbations (AEs) in children.
Methods:
Using the Mayo Clinic birth cohort, we identified children with a diagnosis of asthma from electronic health records. We defined onset date as the date when subjects first met predetermined asthma criteria ascertained by an electronic health records-based natural language processing algorithm. Delay in diagnosis (DD) was defined as first diagnosis >30 days from onset date (vs timely diagnosis [TD] within 30 days). The primary outcome was AE after the index date (for DD: first diagnosis date vs for TD: clinic visit at similar delay from diagnosis as matched DD counterpart). A Cox proportional hazard model was used to test the association between delayed diagnosis status and risk of AE, adjusting for sociodemographics, care quality, and asthma severity.
Results:
Among 537 matched pairs of DD and TD (median age at index date: 4.1 years), a total of 344 and 253 children in DD and TD, respectively, had ≥1 AE during median follow-up period of 9.3 years. Children in the DD group had a significantly increased risk of AE compared to TD (adjusted hazard ratio: 1.53; 95% CI: 1.28, 1.80; P < .001).
Conclusions:
DD of asthma in children is associated with an increased risk of AE compared to TD. TD of asthma should be an important priority in childhood asthma management.
Related Concept Videos
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:29Asthma-I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History