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Author Swern, A.S.; Tozzi, C.A.; Knorr, B.; Bisgaard, H. url  doi
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  Title Predicting an asthma exacerbation in children 2 to 5 years of age Type Journal Article
  Year (down) 2008 Publication Annals of Allergy, Asthma & Immunology Abbreviated Journal Ann Allergy Asthma Immunol  
  Volume 101 Issue 6 Pages 626-630  
  Keywords Acetates/administration & dosage/therapeutic use; Adrenergic beta-Agonists/*administration & dosage/therapeutic use; Anti-Asthmatic Agents/*administration & dosage/therapeutic use; Asthma/*physiopathology/*prevention & control; Child, Preschool; Cough/physiopathology; Drug Administration Schedule; Humans; Multivariate Analysis; Prognosis; Quinolines/administration & dosage/therapeutic use; Remission, Spontaneous; Respiratory Sounds/physiopathology; Severity of Illness Index  
  Abstract BACKGROUND: Asthma exacerbations in young children are prevalent. Identification of symptoms or other factors that are precursors of asthma exacerbations would be useful for early treatment and prevention. OBJECTIVES: To determine whether diary symptoms and beta2-agonist use before an exacerbation could predict an asthma exacerbation in children 2 to 5 years of age. METHODS: Post hoc analyses were conducted on data collected in a study of 689 patients 2 to 5 years of age with asthma symptoms, randomly assigned to montelukast, 4 mg, or placebo daily for 12 weeks. During the study, 196 patients had an exacerbation. Caregiver-reported information (daytime cough, breathing difficulties, limitation of activity, nighttime cough or awakening, daytime and nighttime beta2-agonist use) were analyzed using general estimating equations with an exchangeable within-subject log odds ratio regression structure to identify predictors of an exacerbation. RESULTS: Average symptom scores and beta2-agonist use increased significantly before exacerbation but at different rates. A combination of daytime cough and wheeze and nighttime beta2-agonist use 1 day before the exacerbation was identified as strongly predictive of an exacerbation. These methods predicted 149 (66.8%) of the exacerbations with a very low false-positive rate of 14.2%. CONCLUSIONS: No individual symptom was predictive of an imminent asthma exacerbation, but a combination of increased daytime cough, daytime wheeze, and nighttime beta2-agonist use 1 day before an asthma exacerbation was a strong predictor of an exacerbation in children.  
  Address Merck Research Laboratories, Rahway, New Jersey 07065, USA. swern_arlene@verizon.net  
  Corporate Author Thesis  
  Impact Factor 02,599 First Author Swern, A.S. Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Senior Author Bisgaard, H.  
  ISSN 1081-1206 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:19119707 Approved no  
  Call Number Serial 131  
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