FEV1 is associated with risk of asthma attacks in a pediatric population

Anne L. Fuhlbrigge, Barrett T. Kitch, A. David Paltiel, Karen M. Kuntz, Peter J. Neumann, Douglas W. Dockery, Scott T. Weiss

Research output: Contribution to journalArticlepeer-review

204 Scopus citations


Background: FEV1 is endorsed by the National Asthma Education and Prevention Program as a means for grading asthma severity. However, few data exist on the relationship between FEV1 and asthma outcomes during long-term follow-up. Objective: We explored the relationship between the percent predicted FEV1 (FEV1%) and subsequent asthma attacks in a longitudinal study of pediatric lung health. Methods: A retrospective cohort of 13,842 children (100,292 observations) seen annually over a 15-year interval was analyzed for measurement of pulmonary function, and a respiratory questionnaire was completed. Up to grade 9, a standard questionnaire was completed by a parent or guardian; thereafter it was completed by the patient. For each observation, the report of an attack during the past year was paired with FEV1 recorded at the field survey 1 year earlier. Results: A progressive decrease in the proportion of individuals reporting an attack was associated with increasing decile of FEV1%. Two categorization schemes for FEV1% were examined: a scheme based on the National Asthma Education and Prevention Program recommendations (<60%, 60%-80%, and >80%), and an alternative scheme (<80%, 80%-100%, and >100%). In multivariate models, FEV1% was an independent predictor of attacks: among the parental report group, the odds ratios were 2.1 (95% CI, 1.3-3.4) and 1.4 (95% CI, 1.2-1.6) for FEV1% < 60% and FEV1% of 60% to 80% compared with FEV1% > 80%, respectively; and among the self-report group, odds ratios were 5.3 (95% CI, 2.2-12.9) and 1.4 (95% CI, 1.2-1.7) for FEV1% < 60% and FEV1% of 60% to 80% compared with FEV1% > 80%, respectively. With the alternative classification scheme, the relationship was similar, but the difference in risk between categories of FEV1% decreased. Conclusion: The strong association between FEV1% and risk of asthma attack over the subsequent year supports an emphasis on objective measures of lung function in assessment of risk for adverse asthma outcomes.

Original languageEnglish (US)
Pages (from-to)61-67
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Issue number1
StatePublished - Jan 2001


  • Asthma
  • Attack
  • FEV
  • Outcome
  • Percent predicted FEV
  • Severity

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