Abstract
Background:Asthma control level is much lower in children.
This study aimed to determine the role of small airway function in
predicting asthma control in preschool children. Method: In
this retrospective cohort study, we enrolled preschool children who
initially diagnosed with asthma and followed up 2 to 3 months by
pediatric pulmonary physicians. Clinical history and lung function
results were collected. Multivariable regression model was applied to
determine risk factors in predicting poor asthma control.
Results: The cohort study was comprised of 219 preschool
children. Sixty-nine of them (31.5%) had poor asthma control. Poor
adherence (14.5% vs 6.0%, p=0.038) and severe airway
hyperresponsiveness (AHR) (20.6% vs 1.6%, p<0.05) were
more common in poor controlled group. Baseline FEV 1%
(94.5 vs 101.4, p=0.001), FEF50% (66.1 vs 86.0,
p<0.001), FEF75% (60.9 vs 75.3, p=0.001),
FEF25-75% (70.9 vs 86.0, p<0.001) were significantly
lower in poor controlled patients than those of well controlled group.
While, FVC% was similar between the two groups (92.4 vs 96.7,
p=0.093). Multivariable regression models showed severe AHR (OR
9.500, 95%CI 1.404-64.000, p=0.020), lower baseline FEF50% (OR
0.972, 95%CI 0.950-0.994, p=0.012) were significantly associated
with short-term poor asthma control (AUC, 0.740, 95%CI 0.661-0.818).
Conclusion: Preschool asthma children with severe AHR and
decreased FEF50 were at risk of poor asthma control in next 2 to 3
months.