Stephen J. Teach, MD, MPH, Peter J. Gergen, MD, MPH, Stanley J

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Presentation transcript:

Seasonal risk factors for asthma exacerbations among inner-city children Stephen J. Teach, MD, MPH, Peter J. Gergen, MD, MPH, Stanley J. Szefler, MD, Herman E. Mitchell, PhD, Agustin Calatroni, MA, MS, Jeremy Wildfire, MS, Gordon R. Bloomberg, MD, Carolyn M. Kercsmar, MD, MS, Andrew H. Liu, MD, Melanie M. Makhija, MD, Elizabeth Matsui, MD, Wayne Morgan, MD, CM, George O'Connor, MD, MS, William W. Busse, MD Journal of Allergy and Clinical Immunology Volume 135, Issue 6, Pages 1465-1473.e5 (June 2015) DOI: 10.1016/j.jaci.2014.12.1942 Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Univariate associations of baseline predictors (total IgE levels, specific IgE levels, number of positive skin test results, and eosinophil counts) and previous season predictors (FEV1/FVC ratio, Feno value, exacerbation in the previous season, and ICS step requirement) with the probability of exacerbation by season. Solid lines are for marginally significant associations (P < .10), and dashed lines are for nonsignificant associations. Journal of Allergy and Clinical Immunology 2015 135, 1465-1473.e5DOI: (10.1016/j.jaci.2014.12.1942) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Multivariate models for associations of baseline and previous season predictors of exacerbations. Baseline predictors were allergy (skin test results and total IgE levels) and age. Previous season predictors were FEV1/FVC ratio, Feno value, exacerbation history, and ICS step requirement. The length and color of the bars indicate the strength of association between the predictor and seasonal exacerbation, as measured by variance explained. The total predictive power of a multivariate model containing all 7 predictors is annotated in the bottom right corner. Negative associations are indicated with an asterisk. Journal of Allergy and Clinical Immunology 2015 135, 1465-1473.e5DOI: (10.1016/j.jaci.2014.12.1942) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Seasonal exacerbation prevalence by risk level. Each participant had an exacerbation risk level calculated for each season using a simple index of 7 risk factors (allergy, age, FEV1/FVC ratio, Feno value, exacerbation in the previous season, and ICS step requirement). Seasonal risk levels were then divided into tertiles (labeled Low, Medium, and High), which are plotted against observed exacerbation rates in the ACE and ICATA studies. An additional risk group (Very High) was added for participants with a risk index in the top 10%. Journal of Allergy and Clinical Immunology 2015 135, 1465-1473.e5DOI: (10.1016/j.jaci.2014.12.1942) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions