title: Asthma-specific quality of life and subsequent asthma emergency hospital care.
abstract: OBJECTIVE
  To identify an optimal cut-point score on the Mini-Asthma Quality of Life Questionnaire (mini-AQLQ) to predict subsequent asthma exacerbations, and to determine the additional risk conferred by a prior history of acute episodes.
  
  
  METHODS
  Cross-sectional survey linked to administrative records.
  
  
  METHODS
  A total of 1006 HMO patients with active asthma completed surveys that included the mini-AQLQ and prior-year history of acute episodes. Surveys were linked to administrative data that captured asthma emergency department and hospital care (emergency hospital care) for the year after the survey. Optimal mini-AQLQ cut-point scores were determined by stepwise logistic regression analyses using subsequentyear asthma emergency hospital care as the outcome and various mini-AQLQ cut-points as the predictors. Predictive properties of the 2 risk factors (mini-AQLQ cut-points and prior acute episodes) were determined.
  
  
  RESULTS
  A mini-AQLQ cut-point of 4.7 was most significantly associated with subsequent exacerbations in patients without a history of prior acute episodes. The presence of either a mini-AQLQ score <4.7 or a history of prior acute episodes provided high sensitivity (90.4%) and identified a group nearly 6 times more likely to require emergency hospital care than patients with neither risk factor. The presence of both risk factors provided high specificity (79.2%) and resulted in a risk ratio of 9.5 compared with the absence of both risk factors.
  
  
  CONCLUSIONS
  Asthma-specific quality of life and a history of acute episodes can be used together to identify patients with clinically meaningful higher and lower risks of subsequent acute exacerbations.
authors.affiliation: Department of Allergy, Kaiser-Permanente Medical Center, 7060 Clairemont Mesa Blvd, San Diego, CA 92111, USA. michael.x.schatz@kp.org
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.forename: Robert S
authors.initials: RS
authors.lastname: Zeiger
authors.forename: David
authors.initials: D
authors.lastname: Mosen
authors.forename: William M
authors.initials: WM
authors.lastname: Vollmer
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000503:physiopathology* / Q000628:therapy*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018434:Sickness Impact Profile