Incidence and predictors of asthma exacerbations in middle-aged and older adults: the Rotterdam Study.
| Autor: | de Roos EW; Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.; Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands., Lahousse L; Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.; Dept of Bioanalysis, Ghent University, Ghent, Belgium., Verhamme KMC; Dept of Bioanalysis, Ghent University, Ghent, Belgium.; Dept of Medical Informatics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands., Braunstahl GJ; Dept of Respiratory Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.; Dept of Respiratory Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands., In 't Veen JJCCM; Dept of Respiratory Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.; Dept of Respiratory Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands., Stricker BH; Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.; Dept of Internal Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands., Brusselle GGO; Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.; Dept of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands.; Dept of Respiratory Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | ERJ open research [ERJ Open Res] 2021 Jul 12; Vol. 7 (3). Date of Electronic Publication: 2021 Jul 12 (Print Publication: 2021). |
| DOI: | 10.1183/23120541.00126-2021 |
| Abstrakt: | Aim: The aim of this study was to investigate occurrence and determinants of asthma exacerbations in an ageing general population. Methods: Subjects aged 45 years or above with physician-diagnosed asthma in the Rotterdam Study, a population-based prospective cohort from January 1991 to May 2018, were assessed for asthma exacerbations. Exacerbations were defined as acute episodes of worsening asthma treated with oral corticosteroids. Cox proportional hazards analysis was used to investigate risk factors for a future exacerbation. Results: Out of 763 participants with asthma (mean age 61.3 years, 69.2% female), 427 (56.0%) experienced at least one exacerbation, in a mean follow-up time of 13.9 years. The mean annual exacerbation rate was 0.22. Most exacerbations occurred during winter months. Risk factors for exacerbations were a history of previous exacerbations (HR 4.25; 95% CI 3.07-5.90, p<0.001)), respiratory complaints (HR 2.18; 95% CI 1.48-3.21, p<0.001), airflow obstruction (HR 1.52; 95% CI 1.07-2.15, p=0.019), obesity (HR 1.38; 95% CI 1.01-1.87, p=0.040) and depressive symptoms (HR 1.55; 95% CI 1.05-2.29, p=0.027). Compared to those not using respiratory medication, we observed higher hazard ratios for those on short-acting β Conclusion: Many older adults with asthma suffer from at least one severe exacerbation. Previous exacerbations, use of SABA without concomitant controller medication, respiratory complaints, obesity, airway obstruction and depression are independent risk factors for exacerbations. Competing Interests: Conflict of interest: E.W. de Roos has nothing to disclose. Conflict of interest: L. Lahousse has nothing to disclose. Conflict of interest: K.M.C. Verhamme works for a research group that received/receives unconditional research grants from Yamanouchi, Pfizer–Boehringer Ingelheim, Novartis, GSK, Chiesi and Amgen. Conflict of interest: G-J. Braunstahl reports grants from GSK, AstraZeneca, Chiesi and Teva, personal fees from Novartis and Sanofi, and grants and personal fees from ALK Abello, outside the submitted work. Conflict of interest: J.J.C.C.M. in ‘t Veen reports faculty grants from Teva, Chiesi, Boehringer Ingelheim and AstraZeneca, and speaker bureau and advisory board fees from Sanofi, outside the submitted work. Conflict of interest: B.H. Stricker has nothing to disclose. Conflict of interest: G.G.O. Brusselle reports advisory board fees from Amgen, Boehringer Ingelheim, Novartis, Sanofi and Teva, and advisory board and lecture fees from AstraZeneca, Chiesi and GlaxoSmithKline, outside the submitted work. (Copyright ©The authors 2021.) |
| Databáze: | MEDLINE |
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