Independent risk factors of asthma exacerbations: 3-year follow-up in a single-center prospective cohort study

Abstract

Background: Because minimizing future risk is the goal of asthma chronic asthma management, it is particularly important to identify risk factors. We conducted this 3-year single-center prospective cohort study to determine the independent risk factors of asthma exacerbations (AEs).Methods: We performed this prospective, longitudinal, observational study with a 3-year follow-up on 257 patients aged 18-81 years with at least a 1-year history of asthma. Follow-up visits are conducted through regular annual phone calls, and the primary endpoints were AE. Results:The uncontrolled group was more likely to develop AE than the well-controlled group [odds ratio (OR): 6.34, 95% confidence interval (CI): 1.14-35.21, P<0.05]. Patients with low Asthma Quality of Life Questionnaire (AQLQ) scores were more likely to develop AE than these with high AQLQ scores (OR: 0.59, 95% CI: 0.35-0.99, P<0.05). AQLQ and Asthma Control Questionnaires (ACQ) were both strong independent risk factors within 3 years of enrollment; the cut-off values (COV) of the AQLQ and the ACQ (uncontrolled) that better evaluated the risk with the AE were ≤5.4 and >1, respectively. The AQLQ scores had a sensitivity of 79.07% and a specificity of 59.09% [area under curve (AUC): 0.70, P<0.0001], and the ACQ (uncontrolled) had a sensitivity of 81.4% and a specificity of 52.29% (AUC 0.68, P<0.0001). Conclusions:The findings of this study suggest that patients with uncontrolled asthma and a diminished health-related quality of life had an increased risk of exacerbations in the future. Defining these risk factors associated with AE is important as it will identify these at the highest risk to patients and may guide future interventions.

Screening of key genes in childhood asthma based on bioinformatics analysis

“…Asthma is the most common chronic respiratory disease in children, and its morbidity and mortality rates continue to increase each year ( 1 , 3 ); thus, asthma represents a serious health and economic burden worldwide and seriously affects the quality of life of patients ( 8 - 11 ). The etiology of asthma is still unclear, but it is generally believed that it is closely related to immune, neurological, mental, endocrine, and genetic factors, and abnormal signaling pathways ( 12 , 13 ).…”

“…Asthma is mainly characterized by recurrent airway obstruction and bronchospasm, and the symptoms in the acute attack stage have a serious effect on children’s physical and mental health ( 1 , 2 ). Currently, asthma requires long-term complex treatment strategies and may rapidly deteriorate in a short period of time ( 3 ). Childhood asthma is closely related to genetic and allergic factors ( 2 , 3 ).…”

“…Currently, asthma requires long-term complex treatment strategies and may rapidly deteriorate in a short period of time ( 3 ). Childhood asthma is closely related to genetic and allergic factors ( 2 , 3 ). Following genome-wide association studies and subsequent validation studies, the gene mutation sites related to childhood asthma have been identified, and research has shown that the ORM1-Like Protein 3 (ORMDL3) / gasdermin A (GSDMA) locus on chromosome 17q12 is closely related to childhood asthma ( 4 ).…”