Chest
Volume 112, Issue 3, September 1997, Pages 582-590
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Clinical Investigations: Asthma
A New Index of Prognostic Severity for Chronic Asthma

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Objective

To develop a prognostic clinical index for adults with chronic stable asthma.

Design

Analysis of data from a 48-week randomized, crossover trial of regular vs as-needed inhaled β-agonist therapy.

Patients

Eligible patients included 70 men and women between the ages of 15 and 64 years with asthma for > 1 year.

Outcome measure

Asthma deterioration within 20 weeks, defined as either a marked decline in FEV1 (≥1.0 L or ≥30% from baseline) or initiation of systemic corticosteroid therapy for asthma exacerbation.

Results

Three baseline factors independently predicted asthma deterioration: frequent symptoms on waking in the 4 weeks before baseline, past hospitalization for asthma, and age 35 years or older. Based on cross-stratification and consolidation of these prognostic factors, an index was developed that stratified subjects into four risk groups with distinctive deterioration rates of 9%, 21%, 39%, and 67% (p<0.001).

Conclusion

For adults with chronic stable asthma, three simple clinical factors can be combined to stratify effectively for risk of subsequent asthma deterioration.

Key words

asthma
clinical severity
prognostic index

Cited by (0)

Dr. Beckett was supported in part by the National Heart, Lung, and Blood Institute, Division of Lung Diseases, Preventive Pulmonary Academic Award. The original trial that provided data for this study was funded by the Health Research Council of New Zealand.