Asthma Exacerbation Risk Factors Differ by Severity

The authors of a recent study have identified risk factors for exacerbations in patients with moderate to mild asthma and severe asthma.

For their study, the researchers assessed 22,130 adult patients who received at least 2 asthma diagnoses and 1 prescription for asthma medication between 2010 and 2011.
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An asthma exacerbation was defined as having a corticosteroid burst characterized by a prescription of high-dose oral corticosteroid for at least 3 days or 1 systemic corticosteroid injection, hospitalization or emergency department visit.

Findings indicated that, in severe asthma, history of corticosteroid bursts was significantly associated with exacerbation.

In mild and moderate asthma, women, individuals aged 45 years or older, and those with gastroesophageal reflux disease or chronic rhinitis were had an increased risk for exacerbation. Furthermore, in mild to moderate asthma, allergic rhinitis and history of hospitalization were strongly associated with exacerbation.

In patients with frequent exacerbations compared with a single exacerbation, individuals with mild to moderate asthma aged 45 years or older and those with atopic dermatitis, anxiety and/or history of corticosteroid burst had a significantly increased risk of exacerbation. However, no risk factors reached significance in those with severe asthma.

“Different associations between risk factors and asthma exacerbations based on asthma severity suggest that patients with mild asthma require greater attention to their age and comorbidities, whereas those with severe asthma require greater attention to hospitalization history and drug adherence,” the researchers concluded

—Christina Vogt

Reference:

Kang HR, Song NJ, Nam JH, et al. Risk factors of asthma exacerbation based on asthma severity: a nationwide population-based observational study in South Korea [Published online March 22, 2018]. BMJ Open. http://dx.doi.org/10.1136/bmjopen-2017-020825.