Characteristics of asthma patients and risk factors of uncontrolled asthma in children

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2020. Objective: To identify factors associated with baseline severity and control of asthma in pediatric patients. Materials and Methods: The medical records of 279 newly diagnosed patients with asthma aged younger than 15 years and that visited Taksin Hospital in Bangkok were reviewed. Demographic and clinical characteristics at first diagnosis and three months after treatment were collected. Medication and treatment compliance were recorded. Asthma control status was classified according to the Global Initiative for Asthma (GINA) guideline. Factors associated with baseline severity and levels of control were determined. Results: Among the 279 pediatric patients with asthma, 48 (17.6%) were severe asthma at time of diagnoses. Patient’s comorbidities, including acute rhinosinusitis, a family history of atopy, and a history of preterm birth, were significantly associated with severe asthma at baseline. Asthma severity can be assessed retrospectively from the level of treatment required to control symptom and exacerbation according to the GINA. At the 3-month visit, 105 (37.6%) patients had uncontrolled asthma. Factors associated with uncontrolled asthma included severe asthma at baseline (RR 4.86, 95% CI 2.96 to 7.99), a family history of atopy (RR 1.54, 95% CI 1.12 to 2.12), acute rhinosinusitis and snoring (RR 1.54, 95% CI 1.09 to 2.17), severe allergic rhinitis (RR 2.32, 95% CI 1.78 to 3.04), poor compliance (RR 4.66, 95% CI 3.36 to 6.45), and aggravated factors (RR 3.88, 95% CI 3.05 to 4.92). Environmental factors, such as owning pets and environmental tobacco smoke, were not associated with asthma control. Conclusion: Good treatment compliance for asthma and other comorbidities are important for well-controlled asthma.