Elida Duenas-Meza, Sarah Pulido-Fentanes, Monica Mendez-Moreno, Nadia Juliana Proaños-Jurado
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Multivariable logistic regression was used to identify independent risk factors for uncontrolled asthma. Results: Of the 228 children included, 35.5% had uncontrolled asthma. Obstructive sleep apnea (OR: 2.16; 95% CI: 1.13-4.11; p = 0.019) and moderate to severe impairment in caregiver quality of life (OR: 12.35; 95% CI: 4.15-36.80; p < 0.001) were independently associated with uncontrolled asthma. Systemic corticosteroid use and hospitalization in the prior year were significantly more common in this group. Lung function was preserved in most children; however, those with uncontrolled asthma exhibited significantly greater bronchodilator reversibility (5.8% vs. 4.1%; p = 0.015) and higher functional variability over time based on conditional FEV<sub>1</sub> change scores (≥ +1.96 z-score in 18.9% vs. 8.5%). Conclusions: uncontrolled asthma in children with SA is associated with comorbid sleep apnea, caregiver burden, and functional variability despite normal spirometric values. These findings underscore the need for multidimensional evaluation, caregiver support, and longitudinal monitoring to optimize asthma control in high-risk pediatric populations.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-14"},"PeriodicalIF":1.3000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk Factors for Uncontrolled Asthma in a Pediatric Population with Severe Asthma: FRAMAG Study.\",\"authors\":\"Elida Duenas-Meza, Sarah Pulido-Fentanes, Monica Mendez-Moreno, Nadia Juliana Proaños-Jurado\",\"doi\":\"10.1080/02770903.2025.2562583\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Severe asthma (SA) in children is associated with significant morbidity, increased healthcare utilization, and reduced quality of life. Despite appropriate treatment, achieving optimal asthma control remains challenging, particularly in pediatric populations. This study aimed to identify factors associated with poor asthma control in children with SA, focusing on clinical, functional, and caregiver-related variables. This retrospective cohort study included children aged 6-17 years with SA followed for up to three years in the Asmaire-Rexpira Program in Bogota, Colombia. Asthma control was defined using a comprehensive composite score integrating symptom questionnaires, exacerbation history, corticosteroid use, hospitalizations, and spirometry. Multivariable logistic regression was used to identify independent risk factors for uncontrolled asthma. Results: Of the 228 children included, 35.5% had uncontrolled asthma. Obstructive sleep apnea (OR: 2.16; 95% CI: 1.13-4.11; p = 0.019) and moderate to severe impairment in caregiver quality of life (OR: 12.35; 95% CI: 4.15-36.80; p < 0.001) were independently associated with uncontrolled asthma. Systemic corticosteroid use and hospitalization in the prior year were significantly more common in this group. Lung function was preserved in most children; however, those with uncontrolled asthma exhibited significantly greater bronchodilator reversibility (5.8% vs. 4.1%; p = 0.015) and higher functional variability over time based on conditional FEV<sub>1</sub> change scores (≥ +1.96 z-score in 18.9% vs. 8.5%). Conclusions: uncontrolled asthma in children with SA is associated with comorbid sleep apnea, caregiver burden, and functional variability despite normal spirometric values. These findings underscore the need for multidimensional evaluation, caregiver support, and longitudinal monitoring to optimize asthma control in high-risk pediatric populations.</p>\",\"PeriodicalId\":15076,\"journal\":{\"name\":\"Journal of Asthma\",\"volume\":\" \",\"pages\":\"1-14\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Asthma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02770903.2025.2562583\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Asthma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02770903.2025.2562583","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 0
摘要
儿童严重哮喘(SA)与显著发病率、医疗保健利用率增加和生活质量下降有关。尽管有适当的治疗,实现最佳哮喘控制仍然具有挑战性,特别是在儿科人群中。本研究旨在确定与SA患儿哮喘控制不良相关的因素,重点关注临床、功能和护理相关变量。这项回顾性队列研究包括6-17岁的SA儿童,在哥伦比亚波哥大的asmire - rexpira项目中随访长达三年。使用综合症状问卷、加重史、皮质类固醇使用、住院和肺活量测定的综合综合评分来定义哮喘控制。采用多变量logistic回归来确定未控制哮喘的独立危险因素。结果:在纳入的228名儿童中,35.5%患有未控制的哮喘。阻塞性睡眠呼吸暂停(OR: 2.16; 95% CI: 1.13-4.11; p = 0.019)和中度至重度照顾者生活质量损害(OR: 12.35; 95% CI: 4.15-36.80; p < 0.001)与未控制的哮喘独立相关。全身性皮质类固醇使用和前一年住院治疗在该组中更为常见。多数患儿肺功能完好;然而,未经控制的哮喘患者表现出更大的支气管扩张剂可逆性(5.8% vs. 4.1%; p = 0.015)和基于条件FEV1变化评分的更高的功能变异性(18.9% vs. 8.5%的z评分≥+1.96)。结论:SA患儿不受控制的哮喘与共病性睡眠呼吸暂停、照顾者负担和功能变异性相关,尽管肺量测量值正常。这些发现强调了多维评估、护理人员支持和纵向监测的必要性,以优化高危儿科人群的哮喘控制。
Risk Factors for Uncontrolled Asthma in a Pediatric Population with Severe Asthma: FRAMAG Study.
Severe asthma (SA) in children is associated with significant morbidity, increased healthcare utilization, and reduced quality of life. Despite appropriate treatment, achieving optimal asthma control remains challenging, particularly in pediatric populations. This study aimed to identify factors associated with poor asthma control in children with SA, focusing on clinical, functional, and caregiver-related variables. This retrospective cohort study included children aged 6-17 years with SA followed for up to three years in the Asmaire-Rexpira Program in Bogota, Colombia. Asthma control was defined using a comprehensive composite score integrating symptom questionnaires, exacerbation history, corticosteroid use, hospitalizations, and spirometry. Multivariable logistic regression was used to identify independent risk factors for uncontrolled asthma. Results: Of the 228 children included, 35.5% had uncontrolled asthma. Obstructive sleep apnea (OR: 2.16; 95% CI: 1.13-4.11; p = 0.019) and moderate to severe impairment in caregiver quality of life (OR: 12.35; 95% CI: 4.15-36.80; p < 0.001) were independently associated with uncontrolled asthma. Systemic corticosteroid use and hospitalization in the prior year were significantly more common in this group. Lung function was preserved in most children; however, those with uncontrolled asthma exhibited significantly greater bronchodilator reversibility (5.8% vs. 4.1%; p = 0.015) and higher functional variability over time based on conditional FEV1 change scores (≥ +1.96 z-score in 18.9% vs. 8.5%). Conclusions: uncontrolled asthma in children with SA is associated with comorbid sleep apnea, caregiver burden, and functional variability despite normal spirometric values. These findings underscore the need for multidimensional evaluation, caregiver support, and longitudinal monitoring to optimize asthma control in high-risk pediatric populations.
期刊介绍:
Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.