A new index of prognostic severity for chronic asthma

Chest. 1997 Sep;112(3):582-90. doi: 10.1378/chest.112.3.582.

Abstract

Objective: To develop a prognostic clinical index for adults with chronic stable asthma.

Design: Analysis of data from a 48-week randomized, crossover trial of regular vs as-needed inhaled beta-agonist therapy.

Patients: Eligible patients included 70 men and women between the ages of 15 and 64 years with asthma for > 1 year.

Outcome measure: Asthma deterioration within 20 weeks, defined as either a marked decline in FEV1 (> or = 1.0 L or > or = 30% from baseline) or initiation of systemic corticosteroid therapy for asthma exacerbation.

Results: Three baseline factors independently predicted asthma deterioration: frequent symptoms on waking in the 4 weeks before baseline, past hospitalization for asthma, and age 35 years or older. Based on cross-stratification and consolidation of these prognostic factors, an index was developed that stratified subjects into four risk groups with distinctive deterioration rates of 9%, 21%, 39%, and 67% (p<0.001).

Conclusion: For adults with chronic stable asthma, three simple clinical factors can be combined to stratify effectively for risk of subsequent asthma deterioration.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Adrenergic beta-Agonists / administration & dosage
  • Adrenergic beta-Agonists / therapeutic use
  • Adult
  • Age Factors
  • Airway Obstruction / physiopathology
  • Asthma / diagnosis*
  • Asthma / drug therapy
  • Asthma / physiopathology
  • Bronchodilator Agents / administration & dosage
  • Bronchodilator Agents / therapeutic use
  • Chronic Disease
  • Circadian Rhythm
  • Cross-Over Studies
  • Female
  • Forced Expiratory Volume / drug effects
  • Forced Expiratory Volume / physiology
  • Forecasting
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps / physiopathology
  • Peak Expiratory Flow Rate / drug effects
  • Peak Expiratory Flow Rate / physiology
  • Prognosis
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Bronchodilator Agents