Risk Factors for Acute Exacerbations in Elderly Asthma: What Makes Asthma in Older Adults Distinctive?
10.4168/aair.2020.12.3.443
- Author:
Kyoung Hee SOHN
1
;
Woo Jung SONG
;
Jong Sook PARK
;
Heung Woo PARK
;
Tae Bum KIM
;
Choon Sik PARK
;
Sang Heon CHO
;
Author Information
1. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul National University College of Medicine, Seoul, Korea. shcho@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Asthma;
elderly;
exacerbation;
risk factors;
airway obstruction
- MeSH:
Adult;
Aged;
Airway Obstruction;
Asthma;
Bayes Theorem;
Cohort Studies;
Delivery of Health Care;
Eosinophils;
Follow-Up Studies;
Forced Expiratory Volume;
Humans;
Logistic Models;
Male;
Risk Factors;
Vital Capacity
- From:Allergy, Asthma & Immunology Research
2020;12(3):443-453
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Asthma in the elderly (EA; ≥ 65 years of age) is increasing, adding a heavy socioeconomic burden to the healthcare system. However, little is known about risk factors associated with acute exacerbations in EA patients. The objective of this study was to investigate risk factors for acute exacerbation in EA compared to non-elderly asthma (NEA).METHODS: We combined data from 3 adult asthma cohorts under a unified protocol and database. Asthmatic patients with regular follow-up during a 1-year period were selected from the cohorts to identify the risk factors predicting acute exacerbations in EA compared to NEA.RESULTS: We selected a total of 1,086 patients from the merged cohort. During the observation period, 503 and 583 patients were assigned to the EA and NEA groups, respectively. The exacerbation rate was 31.0% in the EA and 33.2% in the NEA group. Multivariate logistic regression analysis revealed fixed airway obstruction, chronic rhinosinusitis (CRS), and male sex as independent risk factors for exacerbation in the EA group. In the NEA group, exacerbation increased along with an increase in eosinophil count. Bayesian analysis of the interactions among clinical factors revealed that forced expiratory volume in 1 second/forced vital capacity was directly related to exacerbation in the EA group, and eosinophil count was related to exacerbation in the NEA group.CONCLUSIONS: We suggest that fixed airway obstruction and CRS as the important clinical factors predicting acute exacerbations in EA, whereas in NEA, eosinophil count was the strong predictor of exacerbation.
