TENOR risk score predicts healthcare in adults with severe or difficult-to-treat asthma

¹ Genentech, Inc, South San Francisco, California
² University of California, San Francisco, California
³ Ovation Research Group, San Francisco, California
⁴ National Jewish Medical and Research Center, Denver, Colorado
⁵ Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School

^* To whom correspondence should be addressed. E-mail: mkmiller{at}gene.com.

	Abstract

Can severe or difficult-to-treat asthma patients at highest risk for healthcare utilization be predicted so as to optimize clinical management?

Data were derived from 2821 adults with asthma enrolled in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study. Multiple potential predictors were assessed at baseline using a systematic algorithm employing stepwise logistic regression. Outcomes were asthma-related hospitalizations or emergency department visits within 6 months following baseline.

Overall, 239 subjects (8.5%) reported hospitalization or emergency department visits at follow-up. Predictors retained after multivariate analysis were: younger age, female gender, non-white race, body mass index 35 kg·m^-2, post bronchodilator percent predicted forced vital capacity <70%, history of pneumonia, diabetes, cataracts, intubation for asthma, and 3 steroid bursts in prior three months. A final risk score derived from the logistic regression model ranged from 0 to 18 and was highly predictive (c-index: 0.78) of hospitalization or emergency department visits. We re-tested this tool in a prospective validation using outcomes at 12-18 month follow-up among the same cohort; that c-index was 0.77.

The risk score derived is a clinically useful tool for assessing the likelihood of asthma-related hospitalization or emergency department visits in adults with severe and difficult-to-treat asthma.

This article has been cited by other articles:

				M. Gaga, E. Zervas, and P. Chanez Update on severe asthma: what we know and what we need Eur. Respir. Rev., June 1, 2009; 18(112): 58 - 65. [Full Text] [PDF]