Asthma diagnosis and treatmentPrognostic factors of asthma severity: A 9-year international prospective cohort study
Section snippets
Study design
The ECRHS is an international multicenter study of asthma. The first survey7 was performed in 1991 to 1993 on random samples of adults age 20 to 44 years. Each participant was sent a brief questionnaire (stage 1), and from subjects who responded, a 20% random sample was invited to undergo a more detailed clinical examination (stage 2). In addition, a symptomatic sample consisting of subjects who reported symptoms of waking with shortness of breath, asthma attacks, or using asthma medication in
Severity of asthma at the end of the follow-up (1999-2001)
At baseline (1991-1993), the mean age of the 856 patients with asthma included in the analysis was 34 years (SD, 7) and the average duration of the disease was 17 years (SD, 11). Nine years later (at the end of the follow-up), 102 (11.9%) were in remission (no symptoms, no exacerbations, no asthma medications in the last year), and 388 (45.3%) had intermittent, 69 (8.1%) mild persistent, 143 (16.7%) moderate persistent, and 154 (18.0%) severe persistent asthma.
Symptom control, lung function, and use of ICSs at baseline (1991-1993)
Patients with asthma in remission
Discussion
Asthma severity was prospectively investigated by using the GINA classification, which consists of a 3-dimensional score based on symptoms, lung function, and medication use.
The main findings of our analysis are as follows:
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The deterioration of lung function plays a central role in predicting moderate/severe asthma, whereas the level of symptom control can help in predicting the probability of remission and whether asthma is going to be intermittent or persistent (mild, moderate, or severe)
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The
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The coordination of the European Community Respiratory Health Survey II was supported by the European Commission as part of their Quality of Life program.
Disclosure of potential conflict of interest: R. De Marco has received reimbursement travel expenses from GlaxoSmithKline. The rest of the authors have declared that they have no conflict of interest.