RT Journal Article
SR Electronic
T1 Risk factors associated with persistent airflow limitation in difficult asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2266
VO 40
IS Suppl 56
A1 Samira Aouadi
A1 Ghada Ben Ali
A1 Sonia Maalej
A1 Ines Zayani
A1 Bechir Zouari
A1 Ali Ben Kheder
A1 Ikram Drira
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2266.abstract
AB Introduction: The clinical manifestations of difficult asthma are heterogeneous. Some patients with difficult asthma develop irreversible airway obstruction, which is associated with poor outcomes.Objective: the aim of the study is to determine clinical characteristics associated with persistent airflow limitation in difficult asthma.Methods: we retrospectively analyzed 48 patients with difficult asthma between 2005 and 2010. Twenty patients (8 female, 12 male) with persistent airflow limitation (post bronchodilator FEV1/FVC ratio < 70%) were compared to 28 patients (13 female, 15 male) with normal post bronchodilator FEV1/FVC ratio. Patients with chronic obstructive pulmonary disease and bronchiectasis were excluded.Results: there was no significant difference between the two groups in age (51 vs 45 years, p=0,17), sex (p=0,66), age of asthma onset (35 vs 32 years, p=0,07), number of hospitalizations (p=0,39) and frequency of exacerbations (p=0,74). Rhinitis was more frequent in patients with normal FEV1/FVC ratio (15% vs 35%). But, the difference was not significant (p=0,11). Gatroesophageal reflux was found in 25% of patients in both groups.Risk factors associated with persistent airflow limitation were as follows: longer duration of asthma (22 vs 9.5 years, p <0.001), current or past smoking (50% vs 21%, p=0.038) and absence of allergy (69% vs 33%, p=0.026). Dust mite sensitization was significantly more frequent in patients with normal FEV1/FVC ratio (26% vs 61%, p=0,33).Conclusion:Smoking, longer disease duration and absence of sensitization seem to be related to persistent airflow limitation in Tunisian patients with difficult asthma.