Clinical and Functional Parallels of Severe Uncontrolled Asthmain Children

Abstract

Context: Over the past 20 years in the Russian Federation the prevalence rate of asthma symptoms was 5.3% in 13-14
year-old adolescent’s and4.7% in7-8 year-old children. Lack of control or partial control over the symptoms of the disease
is recorded in more than half of the patients and is the risk of adverse outcomes. The purpose is to identify the markers of
severe uncontrolled progression of bronchial asthma in children.
Place, time and rationale: The study was conducted in the Regional Children’s Clinical Hospital of Chita in 2015-2017.
Materials and methods: In total 112 children aged 1 to 18 years were surveyed. For an in-depth study, 68 children with
well-controlled asthma and 32 patients with uncontrolled asthma progression were selected.
The statistical analysis used: Comparison of independent groups by the Mann-Whitney test, Spearman’s correlation
coefficient and Cramer’s contingency coefficient, calculation of the odds ratio (OR) were used as statistic processing
techniques. Differences were considered statistically significant at p <0.05.
Findings: The authors established significance of frequent acute respiratory viral infections with an obstructive component
in children aged under 3 years old (OR=3.7), and hereditary history of both parents (OR = 3.4). The risk of uncontrolled
progression increased by 2.5 times against the background of comorbid allergic rhinitis (OR = 2.5). Uncontrolled
progression was detected more frequently by 3.7 times in females, and also at puberty (OR = 3.73). In the clinical pattern, a
low degree of bronchial asthma control is characterized predominantly by a multi-trigger type of exacerbation (ARVI,
physical activity, exposure to allergens predominate in the structure of triggers), a high frequency of pulmonary
hyperinflation with uneven ventilation (81.3%) and a predominantly eosinophilic variant of bronchial tree inflammation.
Conclusion: The high frequency of uncontrolled progression (28.6%) is associated with controlled and uncontrolled
causes. Clarification of significant factors will enable to form tactics of maintaining patient data in the conditions of
outpatient and specialized care.