title: Rates and predictors of uncontrolled bronchial asthma in elderly patients from western Romania.
abstract: OBJECTIVE
  Bronchial asthma (BA) is a chronic inflammatory disorder of the airways, featuring variable and often reversible airflow limitations. An accurate assessment of BA control is difficult in practice, especially in the elderly, requiring the assessment of several clinical and paraclinical parameters that are influenced not only by asthma, but also by comorbidities. The purpose of this study was to evaluate the predictors of uncontrolled BA in a group of elderly patients from western Romania.
  
  
  METHODS
  We retrospectively evaluated 126 elderly patients (aged $ 65 years), who were consecutively evaluated in the Pulmonology Department of Victor Babes Hospital, Timisoara, Romania, between March 2009 and July 2012. We collected demographic data, performed pulmonary function testing and an asthma control test (ACT), and evaluated the level of BA control based on the 2012 Global Initiative for Asthma guidelines. Statistical processing of the data was done using the Epi Info and STATA programs.
  
  
  RESULTS
  In our study group, 36 (29%) patients were men and 90 (71%) were women; their mean age was 74.42±8.32 years (range: 65-85 years). A total of 14.28% of patients were smokers. About 30.15% of patients had an ACT score <19, 54.76% had an ACT score 20-24, and 15.09% had an ACT of 25. Moreover, 59.52% had normal spirometry results. Infectious exacerbations were found in 58.73% of patients. A history of allergies was demonstrated in 48.41% of patients, 34.12% had occupational exposure, and 82.53% of patients were treated with inhaled corticosteroids. Our results showed that 30.15% of patients had uncontrolled BA. We found six predictive factors for uncontrolled BA: infectious exacerbation, occupational exposure, mixed (obstructive and restrictive) ventilatory dysfunction, persistent airway obstruction on spirometry, duration of disease in months, and current smoking status. Infectious exacerbations, persistent airway obstructions, and occupational exposure were the most powerful predictors.
  
  
  CONCLUSIONS
  Elderly patients represent an important group that is at risk for developing uncontrolled BA. Predictors may identify those elderly patients with uncontrolled BA and facilitate early medical interventions.
authors.affiliation: Department of Infectious Diseases, Pulmonology, Epidemiology and Parasitology, Timisoara, Romania.
authors.forename: Iosif
authors.initials: I
authors.lastname: Marincu
authors.affiliation: Department of Infectious Diseases, Pulmonology, Epidemiology and Parasitology, Timisoara, Romania.
authors.forename: Stefan
authors.initials: S
authors.lastname: Frent
authors.affiliation: Department of Internal Medicine I, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Mirela Cleopatra
authors.initials: MC
authors.lastname: Tomescu
authors.affiliation: Department of Infectious Diseases, Pulmonology, Epidemiology and Parasitology, Timisoara, Romania.
authors.forename: Stefan
authors.initials: S
authors.lastname: Mihaicuta
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects; D012129:Respiratory Function Tests; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents
keywords: comorbidities; predictors; smokers; spirometry