Longitudinal asthma exacerbation phenotypes in the Korean childhood asthma study cohort. Issue 4 (7th April 2022)

• Record Type: Journal Article
• Authors: Park, Ji Soo; Suh, Dong In; Song, Dae Jin; Baek, Hey‐Sung; Shin, Meeyong; Yoo, Young; Kwon, Ji‐Won; Jang, Gwang Cheon; Yang, Hyeon‐Jong; Lee, Eun; Kim, Hwan Soo; Seo, Ju‐Hee; Woo, Sung‐Il; Kim, Hyung Young; Shin, Youn Ho; Lee, Ju Suk; Yoon, Jisun; Jung, Sungsu; Han, Minkyu; Eom, Eunjin; Yu, Jinho; Kim, Woo Kyung; Lim, Dae Hyun; Kim, Jin Tack
• Is Part Of: Pediatric allergy and immunology. Volume 33:Issue 4(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-04-07
• Subjects: asthma control test -- asthma exacerbation -- asthma phenotype -- exacerbation‐prone asthma -- Korean childhood asthma study -- neutrophilic asthma -- pediatric asthma; Allergy in children -- Periodicals; Immunologic diseases in children -- Periodicals; 617
• DOI: 10.1111/pai.13772
• Languages: English
• ISSNs: 0905-6157

Abstract

Abstract: Background: Asthma exacerbation (AE) leads to social and economic costs and long‐term adverse outcomes. We aimed to predict exacerbation‐prone asthma (EPA) in children. Methods: The Korean childhood Asthma Study (KAS) is a prospective nationwide pediatric asthma cohort of children aged 5–15 years followed every 6 months. Patients with AE during the 6 months prior to all three visits, with AE prior to one or two visits, and without AE prior to any visit were defined as having EPA, exacerbation‐intermittent asthma (EIA), and exacerbation‐resistant asthma (ERA), respectively. Risk factors and prediction models of EPA were explored. Results: Of the 497 patients who completed three visits, 42%, 18%, and 15% had exacerbations prior to visits 1, 2, and 3 and 5%, 47%, and 48% had EPA, EIA, and ERA, respectively. Univariate and multivariable logistic regression revealed forced expiratory volume in 1 s (FEV1) z‐score, forced vital capacity (FVC) z‐score, white blood cell (WBC) count, and asthma control test (ACT) score as relevant EPA risk factors. The EPA prediction model comprised FVC z‐score, WBC count, ACT score, sex, and parental education level (area under the receiver operating characteristic curve [AUROC] 0.841 [95% confidence interval (CI): 0.728–0.954]). Conclusion: With appropriate management, AE decreases over time, but persistent AEs may occur. Apart from asthma control level, baseline lung function and WBC count predicted EPA.