Persistence of Airflow Obstruction in Asthmatic Children
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Lori Banka, DO, Yang Lu, PhD, Lyne G. Scott, MD FAAAAI, Salima A. Thobani, M.D., Marilyn Li, M.D., Cindy Xi, MD, Kenny Y. Kwong
Rationale:  Chronic lung injury during early childhood may lead to abnormal lung function persisting into adolescence.  This study endeavors to determine whether children with asthma who initially present with low lung function continue to have ongoing airflow obstruction despite optimal asthma treatment.

Methods: This is a 5 year retrospective study involving asthmatic children, aged 6 to 14 enrolled in a pediatric asthma disease management program (Breathmobile).  Patients had at least 1 spirometric assessment per year and received asthma care in accordance with 2007 NHLBI-EPR-3 asthma guidelines.  Patients were divided into 2 groups, one with mean FEV1 and FEV1/FVC < 80% predicted and the second group with these mean values > 80% predicted during the first year of treatment.  Outcome was FEV1 and FEV1/FVC % predicted of these patients over subsequent 4 years.

Results:  621 patients were enrolled with 2711 visits.  Mean age of patients was 9.3 years.  30%, 18%, 32% and 20% of patients had intermittent, mild, moderate and severe persistent asthma at initial evaluation.  Patients with FEV1% and FEV1/FVC% <80% predicted during first year of enrollment was associated with increased odds ratio of 19 (p<0.01) and 21 (p<0.01) of having respective values <80% predicted over subsequent 4 years. 

Conclusions:  Airflow obstruction persists in asthma children with early lung functions despite optimal guideline based therapy.