Asthma control and future asthma-related morbidity in inner-city asthmatic children.
BACKGROUND
Asthma guidelines recommend routine evaluation of asthma control, which includes measurements of impairment and risk. It is unclear whether rigorous asthma control changes risk of asthma morbidity.


OBJECTIVE
To examine whether the degree of asthma control in inner-city asthmatic children results in differential risk reduction of future asthma-related morbidity.


METHODS
This retrospective observational study examines 960 inner-city children with asthma who were highly engaged in an asthma-specific disease management program for a minimum of 2 years. Degree of asthma control was determined during the first year of enrollment and was categorized as well controlled (> or = 80% of visits in control), moderately controlled (50%-79% of visits in control), or difficult to control (< 50% of visits in control). Risk and probability of asthma-related morbidity at each visit were determined during the second year of enrollment and included self-reported asthma exacerbations requiring systemic corticosteroid rescue and emergency department visits or hospitalizations.


RESULTS
Increasing the degree of asthma control measured during the first year of enrollment led to statistically significant incremental reductions in risk of acute asthma exacerbations and emergency department visits or hospitalizations during the second year of enrollment.


CONCLUSIONS
Achieving and maintaining asthma control in inner-city children with asthma results in significant reductions in asthma-related morbidity. Systematic assessments of asthma control may be useful for predicting future risk in children with asthma.
Kwong
Kenny Y C
KY
Division of Allergy and Immunology, Department of Pediatrics, Los Angeles County + University of Southern California Medical Center and Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. kkwongusc@yahoo.com
Morphew
Tricia
T
Scott
Lyne
L
Guterman
Jeffrey
J
Jones
Craig A
CA
D000293:Adolescent; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009017:Morbidity; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014504:Urban Health / Q000706:statistics & numerical data*