Risk factors associated with poor controlled pediatric asthma in a university hospital.
BACKGROUND
Many studies in adults had identified factors associated with partly or uncontrolled asthma. In children, factors related to asthma control were not well defined.


OBJECTIVE
To find the factors related to partly or uncontrolled asthma in children.


METHODS
Asthmatic children who had severity at least in the mild persistent level, were recruited. The asthma control levels were classified as controlled, partly controlled and uncontrolled according to the GINA guideline. Risk factors were compared between the patients with controlled and partly controlled/ uncontrolled asthma groups.


RESULTS
One hundred and ten patients (42.7% females) were included. The mean age was 10.3 ± 2.7 years old. There were 55 patients (50%) in the controlled, 54 patients(49.1%) in partly controlled and 1 patient (0.9%) in uncontrolled asthma group. For asthma severity, 97 patients (88.2%) were in mild persistent, 11 patients (10%) in moderate persistent and 2 patients (1.8%) in severe persistent groups. The risk factors for partly controlled/ uncontrolled asthma compared to controlled asthma were moderate/ severe persistent asthma (adjusted OR 18.87 (95% CI 1.92 - 200.00)) and sinusitis (p = 0.04). Using the air conditioner decreased risk of partly controlled/uncontrolled asthma (adjusted OR 0.30 (95% CI 0.10 - 0.91)). The proportion of patients who used medium dose inhaled corticosteroid (ICS) plus long-acting inhaled β2-agonist (LABA) were significantly higher in partly controlled/ uncontrolled asthma than controlled asthma (p = 0.004).


CONCLUSIONS
Risk factors associated with partly controlled/ uncontrolled asthma were moderate/ severe persistent asthma and sinusitis. Using air conditioner seemed to reduce risk of partly controlled/ uncontrolled asthma.
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Ratchadaporn
R
Papwijitsil
Punchama
P
Pacharn
Nichanun
N
Areegarnlert
Jittima
J
Veskitkul
Nualanong
N
Visitsunthorn
Pakit
P
Vichyanond
Orathai
O
Jirapongsananuruk
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage*; D000328:Adult; D001249:Asthma / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012852:Sinusitis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology
D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists