A clinical index to define risk of asthma in young children with recurrent wheezing

被引:816
作者
Castro-Rodríguez, JA [1 ]
Holberg, CJ [1 ]
Wright, AL [1 ]
Martinez, FD [1 ]
机构
[1] Univ Arizona, Coll Med, Resp Sci Ctr, Tucson, AZ USA
关键词
D O I
10.1164/ajrccm.162.4.9912111
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Because most cases of asthma begin during the first years of life, identification of young children at high risk of developing the disease is an important public health priority. We used data from the Tucson Children's Respiratory Study to develop two indices for the prediction of asthma. A stringent index included frequent wheezing during the first 3 yr of life and either one major risk factor (parental history of asthma or eczema) or two of three minor risk factors (eosinophilia, wheezing without colds, and allergic rhinitis). A loose index required any wheezing during the first 3 yr of life plus the same combination of risk factors described previously. Children with a positive loose index were 2.6 to 5.5 times more likely to have active asthma between ages 6 and 13 than children with a negative loose index. Risk of having subsequent asthma increased to 4.3 to 9.8 times when a stringent index was used. We found that 59% of children with a positive loose index and 76% of those with a positive stringent index had active asthma in at least one survey during the school years. Over 95% of children with a negative stringent index never had active asthma between ages 6 and 13. We conclude that the subsequent development of asthma can be predicted with reasonable accuracy using simple, clinically based parameters.
引用
收藏
页码:1403 / 1406
页数:4
相关论文
共 17 条
[1]   EFFECTS OF LONG-TERM TREATMENT WITH AN INHALED CORTICOSTEROID ON GROWTH AND PULMONARY-FUNCTION IN ASTHMATIC-CHILDREN [J].
AGERTOFT, L ;
PEDERSEN, S .
RESPIRATORY MEDICINE, 1994, 88 (05) :373-381
[2]  
Armitage P, 1987, Statistical methods in medical research, V2nd
[3]  
Carlsen KH, 1997, PEDIAT ALLERG IMM-UK, V8, P40
[4]   Can we predict which wheezy infants will continue to wheeze? [J].
Clough, JB ;
Keeping, KA ;
Edwards, LC ;
Freeman, WM ;
Warner, JA ;
Warner, JO .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1999, 160 (05) :1473-1480
[5]   Diagnosing and treating chesty infants [J].
Cochran, D .
BRITISH MEDICAL JOURNAL, 1998, 316 (7144) :1546-1547
[6]   COMPARISON OF A BETA-2-AGONIST, TERBUTALINE, WITH AN INHALED CORTICOSTEROID, BUDESONIDE, IN NEWLY DETECTED ASTHMA [J].
HAAHTELA, T ;
JARVINEN, M ;
KAVA, T ;
KIVIRANTA, K ;
KOSKINEN, S ;
LEHTONEN, K ;
NIKANDER, K ;
PERSSON, T ;
REINIKAINEN, K ;
SELROOS, O ;
SOVIJARVI, A ;
STENIUSAARNIALA, B ;
SVAHN, T ;
TAMMIVAARA, R ;
LAITINEN, LA .
NEW ENGLAND JOURNAL OF MEDICINE, 1991, 325 (06) :388-392
[7]   ATOPY IN SUBJECTS WITH ASTHMA FOLLOWED TO THE AGE OF 28 YEARS [J].
KELLY, WJW ;
HUDSON, I ;
PHELAN, PD ;
PAIN, MCF ;
OLINSKY, A .
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1990, 85 (03) :548-557
[8]   Cold air challenge at age 6 and subsequent incidence of asthma - A longitudinal study [J].
Lombardi, E ;
Morgan, WJ ;
Wright, AL ;
Stein, RT ;
Holberg, CJ ;
Martinez, FD .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1997, 156 (06) :1863-1869
[9]   Reservoir characterization as a risk-reduction tool at the Nash Draw Pool [J].
Martin, FD ;
Murphy, MB ;
Stubbs, BA ;
Uszynski, BJ ;
Hardage, BA ;
Kendall, RP ;
Whitney, EM ;
Weiss, WW .
SPE RESERVOIR EVALUATION & ENGINEERING, 1999, 2 (02) :169-179
[10]   Recognizing early asthma [J].
Martinez, FD .
ALLERGY, 1999, 54 :24-28