소아 천식의 잦은 악화 예측 인자: 알레르기 동반 질환 및 제2형 바이오마커와의 관련성

Abstract

Purpose: Frequent exacerbations (FEs) of asthma often present with poor response to standardized treatment and are associated with an unfavorable prognosis. However, the risk factors for FEs in children remain unclear. Methods: This retrospective study reviewed pediatric patients with asthma between January 2016 and August 2022 at a tertiary center in South Korea. Over 2 years, we followed up patients with FEs defined as 2 or more emergency department visits or hospitalizations for asthma exacerbations per year. Results: Of 558 patients, 56 were classified as FEs. Multivariate regression analysis identified younger age (odds ratio [OR], 2.75; P=0.002), higher steps of asthma management (OR, 10.88; P<0.001), comorbid allergic rhinitis (OR, 0.38; P=0.003), comorbid food allergies (OR, 2.60; P=0.003), and sensitization to class 1 food allergens (OR, 3.08; P=0.001) as significant risk factors for FEs. Additionally, eosinophil cationic protein levels (OR, 0.99; P=0.001) and white blood cell counts (OR, 1.60; P=0.001) were identified as laboratory predictors. In subgroup analysis by age 6, higher asthma management steps (P=0.005 and P=0.046) and class 1 food allergen sensitization (P=0.037 and P=0.026) were consistently identified as significant risk factors for FEs in both age subgroups. Conclusion: It is suggested that younger age, absence of comorbid allergic rhinitis, presence of comorbid food allergy, and class 1 food allergen sensitization may be the potential predictors of FEs in pediatric asthma patients.