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

doi:10.1067/mai.2001.111590

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

Health Policy and Management

Research output: Contribution to journal › Article › peer-review

238 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	61-67
Number of pages	7
Journal	Journal of Allergy and Clinical Immunology
Volume	107
Issue number	1
DOIs	https://doi.org/10.1067/mai.2001.111590
State	Published - Jan 2001

Bibliographical note

Funding Information:
From aChanning Laboratory, Brigham and Women’s Hospital, Harvard Med-ical School, Boston, Massachusetts; bYale School of Medicine and Yale School of Management, New Haven; c Center for Risk Analysis, Harvard School of Public Health, Boston; and dDepartment of Environmental Health, Harvard School of Public Health, Boston. Sponsored by AstraZeneca Pharmaceuticals and the National Heart Lung and Blood Institute, NIH (1-K08 HL03919-01 and HL07427). Reprint requests: Anne L. Fuhlbrigge, MD, MS, Channing Laboratory, 181 Longwood Ave, Boston, MA 02115-5805. Copyright © 2001 by Mosby, Inc. 0091-6749/2001 $35.00 + 0 1/81/111590 doi:10.1067/mai.2001.111590

Keywords

Asthma
Attack
FEV
Outcome
Percent predicted FEV
Severity

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1067/mai.2001.111590

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@article{aff66f7af5b2454ba96bbce26c32ac6e,

title = "FEV1 is associated with risk of asthma attacks in a pediatric population",

abstract = "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.",

keywords = "Asthma, Attack, FEV, Outcome, Percent predicted FEV, Severity",

author = "Fuhlbrigge, {Anne L.} and Kitch, {Barrett T.} and Paltiel, {A. David} and Kuntz, {Karen M.} and Neumann, {Peter J.} and Dockery, {Douglas W.} and Weiss, {Scott T.}",

note = "Funding Information: From aChanning Laboratory, Brigham and Women{\textquoteright}s Hospital, Harvard Med-ical School, Boston, Massachusetts; bYale School of Medicine and Yale School of Management, New Haven; c Center for Risk Analysis, Harvard School of Public Health, Boston; and dDepartment of Environmental Health, Harvard School of Public Health, Boston. Sponsored by AstraZeneca Pharmaceuticals and the National Heart Lung and Blood Institute, NIH (1-K08 HL03919-01 and HL07427). Reprint requests: Anne L. Fuhlbrigge, MD, MS, Channing Laboratory, 181 Longwood Ave, Boston, MA 02115-5805. Copyright {\textcopyright} 2001 by Mosby, Inc. 0091-6749/2001 $35.00 + 0 1/81/111590 doi:10.1067/mai.2001.111590",

year = "2001",

month = jan,

doi = "10.1067/mai.2001.111590",

language = "English (US)",

volume = "107",

pages = "61--67",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Mosby Inc.",

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}

TY - JOUR

T1 - FEV1 is associated with risk of asthma attacks in a pediatric population

AU - Fuhlbrigge, Anne L.

AU - Kitch, Barrett T.

AU - Paltiel, A. David

AU - Kuntz, Karen M.

AU - Neumann, Peter J.

AU - Dockery, Douglas W.

AU - Weiss, Scott T.

N1 - Funding Information: From aChanning Laboratory, Brigham and Women’s Hospital, Harvard Med-ical School, Boston, Massachusetts; bYale School of Medicine and Yale School of Management, New Haven; c Center for Risk Analysis, Harvard School of Public Health, Boston; and dDepartment of Environmental Health, Harvard School of Public Health, Boston. Sponsored by AstraZeneca Pharmaceuticals and the National Heart Lung and Blood Institute, NIH (1-K08 HL03919-01 and HL07427). Reprint requests: Anne L. Fuhlbrigge, MD, MS, Channing Laboratory, 181 Longwood Ave, Boston, MA 02115-5805. Copyright © 2001 by Mosby, Inc. 0091-6749/2001 $35.00 + 0 1/81/111590 doi:10.1067/mai.2001.111590

PY - 2001/1

Y1 - 2001/1

N2 - 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.

AB - 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.

KW - Asthma

KW - Attack

KW - FEV

KW - Outcome

KW - Percent predicted FEV

KW - Severity

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