Longitudinal asthma exacerbation phenotypes in the Korean childhood asthma study cohort
- 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
- Issue Date
- Apr-2022
- Publisher
- John Wiley and Sons Inc
- Keywords
- asthma control test; asthma exacerbation; asthma phenotype; exacerbation-prone asthma; Korean childhood asthma study; neutrophilic asthma; pediatric asthma
- Citation
- Pediatric Allergy and Immunology, v.33, no.4
- Journal Title
- Pediatric Allergy and Immunology
- Volume
- 33
- Number
- 4
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/61473
- DOI
- 10.1111/pai.13772
- ISSN
- 0905-6157
1399-3038
- 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. © 2022 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
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