Published online July 24, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. e347-e355 (doi:10.1542/peds.2005-2962)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fuhlbrigge, A. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fuhlbrigge, A. L.
Related Collections
Right arrow Asthma
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Forced Expiratory Volume in 1 Second Percentage Improves the Classification of Severity Among Children With Asthma

Anne L. Fuhlbrigge, MDa, Scott T. Weiss, MDa, Karen M. Kuntz, ScDb, A. David Paltiel, PhDc for the CAMP Research Group

a Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
b Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts
c Yale School of Medicine, New Haven, Connecticut

OBJECTIVE. Spirometry is an important component of the National Asthma Education and Prevention Program guidelines for asthma, yet published data show variable associations between forced expiratory volume in 1 second percentage (FEV1%) predicted, symptoms and health care utilization. The objective of this analysis was to examine the association between FEV1% and future risk of exacerbations among a well-characterized population of children with asthma.

METHODS. Using data that are available from the Childhood Asthma Management Program, we examined the relationship between prebronchodilator FEV1% and important clinical outcomes. Multiple observations of FEV1 were available for each patient; multivariate regression analysis, using a general estimating equation approach, was used to control for the correlation between repeated measurements among individuals and potential confounders. FEV1% was categorized into 4 levels and as a continuous variable. Outcomes of interest included mean symptom score (0–3), episode-free days, and asthma-related events (oral steroid use, emergency department visits, and hospitalizations) during the ensuing 4-month period. Our analysis was limited to the placebo group (N = 417).

RESULTS. We observed a clear relationship between prebronchodilator FEV1% and important clinical outcomes. In multivariable models that simultaneously controlled for covariates of interest, age at baseline, time, previous event history, and nocturnal awakenings, a significant relationship between FEV1% and asthma symptoms and serious asthma exacerbations (oral steroids, emergency department visits, and hospitalizations) was observed. Compared with children with an FEV1% ≥100%, children with FEV1% 80% to 99%, 60% to 79%, and <60% were 1.3, 1.8, and 4.8, respectively, more likely to have a serious asthma exacerbation during the ensuing 4 months.

CONCLUSIONS. In children with mild to moderate asthma, FEV1% predicted is independently associated with future asthma symptoms and health care utilization. Previous asthma-related hospitalizations and nocturnal symptoms also were independently associated with risk for future adverse events. FEV1 is an important component of asthma health status and asthma severity classification.

Key Words: asthma • spirometry • treatment outcome • severity classification

Abbreviations: NAEPP—National Asthma Education and Prevention Program • FEV1—forced expiratory volume in 1 second • FEV1%—forced expiratory volume in 1 second percentage • CAMP—Childhood Asthma Management Program • EFD—episode-free day

Accepted Mar 2, 2006.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
H. K. Reddel, D. R. Taylor, E. D. Bateman, L.-P. Boulet, H. A. Boushey, W. W. Busse, T. B. Casale, P. Chanez, P. L. Enright, P. G. Gibson, et al.
An Official American Thoracic Society/European Respiratory Society Statement: Asthma Control and Exacerbations: Standardizing Endpoints for Clinical Asthma Trials and Clinical Practice
Am. J. Respir. Crit. Care Med., July 1, 2009; 180(1): 59 - 99.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Sharma, B. A. Raby, G. M. Hunninghake, M. Soto-Quiros, L. Avila, A. J. Murphy, J. Lasky-Su, B. J. Klanderman, J. S. Sylvia, S. T. Weiss, et al.
Variants in TGFB1, Dust Mite Exposure, and Disease Severity in Children with Asthma
Am. J. Respir. Crit. Care Med., March 1, 2009; 179(5): 356 - 362.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
E. Bouzigon, V. Siroux, M-H. Dizier, A. Lemainque, C. Pison, M. Lathrop, F. Kauffmann, F. Demenais, and I. Pin
Scores of asthma and asthma severity reveal new regions of linkage in EGEA study families
Eur. Respir. J., August 1, 2007; 30(2): 253 - 259.
[Abstract] [Full Text] [PDF]

Home page
 JWatch PediatricsHome page
The Value of Office Spirometry in Children
Journal Watch Pediatrics and Adolescent Medicine, September 20, 2006; 2006(920): 4 - 4.
[Full Text]

Home page
 JWatch GeneralHome page
The Value of Office Spirometry in Children
Journal Watch (General), September 14, 2006; 2006(914): 8 - 8.
[Full Text]