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Risk factors for asthma attacks and poor control in children: a prospective observational study in UK primary care

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posted on 2024-03-26, 15:16 authored by D Lo, C Beardsmore, D Roland, M Richardson, Y Yang, L Danvers, A Wilson, EA Gaillard

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.

History

Author affiliation

Department of Respiratory Sciences, University of Leicester

Version

  • AM (Accepted Manuscript)

Published in

Archives of Disease in Childhood

Volume

107

Issue

1

Pagination

26 - 31

Publisher

BMJ

issn

0003-9888

eissn

1468-2044

Copyright date

2021

Available date

2024-03-26

Spatial coverage

England

Language

eng

Data Access Statement

Data are available on reasonable request. The datasets used and analysed for this study are available from the corresponding author on reasonable request.

Rights Retention Statement

  • No