Article Text

other Versions

  • You are currently viewing an earlier version of this article (July 05, 2007).

PDF

Severity of obstructive airways disease by two years predicts asthma at 10 years of age
  1. Chandra Sekhar Devulapalli (c.s.devulapalli{at}medisin.uio.no)
  1. Department of Paediatrics, Division of Woman and Child, Ullevål University Hospital, Norway
    1. Karin C. Lødrup Carlsen (k.c.l.carlsen{at}medisin.uio.no)
    1. Division of Woman and Child, Ullevål University Hospital, University of Oslo, Norway
      1. Geir Håland (geir.haland{at}medisin.uio.no)
      1. Division of Woman and Child, Ullevål University Hospital, Norway
        1. Monica Cheng Munthe-Kaas (m.c.munthe-kaas{at}medisin.uio.no)
        1. Division of Woman and Child, Ullevål University Hospital, Norway
          1. Morten Pettersen (morten.pettersen{at}rikshospitalet.no)
          1. Voksentoppen, Dept. of Paediatrics,Rikshospitalet- Radiumhospitalet Medical Center, Oslo, Norway
            1. Petter Mowinckel (petter.mowinckel{at}ulleval.no)
            1. Division of Woman and Child, Ullevål University Hospital, Norway
              1. Kai Håkon Carlsen (k.h.carlsen{at}medisin.uio.no)
              1. Voksentoppen, Dept. of Paediatrics,Rikshospitalet- Radiumho, Faculty of Medicine, University of Oslo, Norway

                Abstract

                Background: Predicting school-age asthma from obstructive airways disease (OAD) in early life is difficult, even considering parental and children's atopic manifestations.

                Study objective: To assess if severity of OAD in the first two years of life predicts asthma at 10 years of age.

                Methods: From a nested case control study within the Environment and Childhood Asthma study, 233 two year old subjects with recurrent (two episodes) of bronchial obstruction (BO)(rBO+) and 216 subjects without BO (rBO-) underwent clinical examination, parental interview, treadmill test and metacholine bronchial hyperresponsiveness (BHR) measurement at 10 years. A severity score at two years was calculated by frequency, persistence of bronchial obstruction and hospital admissions due to OAD.

                Main outcomes: Current asthma at 10 years (asthma with symptoms and/or asthma medication during the last year and/or positive treadmill test). Secondary outcome; metacholine BHR at 10 years.

                Results: Compared to rBO- subjects; adjusted odds ratio (95 % confidence intervals) of current asthma among rBO+ was 7.9 (4.1, 15.3), among rBO+ with severity score >5: 20.2 (9.9, 41.3). In ROC analysis, positive and negative predictive values demonstrated the applicability and value of the score with optimal cut off at severity score 5. Children with severity score >5 had more often severe BHR (PD20-metacholine < 1 µmol) than children with a lower or 0 score (p=0.0041).

                Conclusion: Using a simple scoring system, a high severity score of OAD by two years of age is a strong risk factor for, and may predict current asthma at ten years of age.

                • Birth cohort
                • Childhood asthma
                • Prediction
                • Risk
                • Severity score

                Statistics from Altmetric.com

                Request permissions

                If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.