[Risk factors for uncontrolled asthma in adults]

Rev Alerg Mex. 2019 Jan-Mar;66(1):65-75. doi: 10.29262/ram.v66i1.557.
[Article in Spanish]

Abstract

Background: Many studies in children had identified risk factors associated with partly or uncontrolled asthma. In adults, factors related to asthma control were not well defined.

Objective: To find the factors related to partly or uncontrolled asthma in adults.

Methods: Asthmatic adults who had severity at least in the mild persistent level, were recruited. The asthma control levels were classified as controlled, partly controlled and uncontrolled according to the Global Initiative for Asthma guideline. Risk factors were compared between the patients with controlled and partly controlled/ uncontrolled asthma groups.

Results: Two hundred (75.5 % females) were included. The mean age was 38.4 ± 11.93 years old. There were 100 patients (50 %) in the controlled and 100 patients (50 %) in partly controlled and uncontrolled asthma group. For asthma severity, 35 patients (88.2 %) were in mild persistent, 14 patients (10 %) in moderate persistent and 97 patients (1.8 %) in severe persistent groups. The absence of stress yielded an OR = 0.41 (95 % CI = 0.23-0.75), p = 0.03. While active smoking, OR = 4.23 (95 % CI = 1.35-13.2), p = 0.007. Patients who have no contact with stuffed animals or rugs have OR = 0.4 (IC 95 % = 0.2-0.79). It was important the result of the patients that if they correctly use their inhalers OR = 0.36 (IC 95 % = 0.13-0.97), p = 0.031.

Conclusions: Current and active smoking and atopic dermatitis are risk factors. As a protective factor to the normal levels of eosinophils in blood, correct use of inhalers, FEV1 > 80 %, the absence of stress and the absence of contact with carpets and stuffed animals.

Antecedentes: Estudios en niños han identificado factores asociados con la falta de control del asma. En adultos no están bien definidos. Objetivo: Identificar los factores relacionados con la falta de control del asma en adultos. Métodos: Se incluyeron adultos con asma clasificados como controlados, parcialmente controlados y no controlados según los criterios de la Global Initiative for Asthma. Resultados: Se incluyeron 200 pacientes (75.5 % mujeres), edad promedio de 38.4 ± 11.93 años. Cien pacientes con asma controlada y 100 con asma no controlada y parcialmente controlada; 35 (88.2 %) con persistencia leve, 14 (10 %) con persistencia moderada y 97 (1.8 %) con persistencia grave; en estrés se encontró RM = 0.41 (IC 95 % = 0.23-0.75), p = 0.03; en tabaquismo actual y activo, RM = 4.23 (IC 95 % = 1.35-13.2), p = 0.007; y en uso correcto de inhaladores, RM = 0.36 (IC 95 % = 0.13-0.97), p = 0.031. Los pacientes no tuvieron contacto con peluches ni alfombras. Conclusiones: Se observó asociación con tabaquismo actual activo y dermatitis atópica. Como factores de protección se identificó niveles normales de eosinófilos en sangre, uso correcto de inhaladores, VEF1 > 80 %, ausencia de estrés y de contacto con alfombras y peluches.

Keywords: Adults; Asthma; GINA.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Asthma / classification
  • Asthma / etiology
  • Asthma / therapy*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Severity of Illness Index
  • Young Adult