Longitudinal trajectories of severe wheeze exacerbations from infancy to school age and their association with early-life risk factors and late asthma outcomes.
asthma exacerbations
childhood asthma
machine learning
primary care data
Journal
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
ISSN: 1365-2222
Titre abrégé: Clin Exp Allergy
Pays: England
ID NLM: 8906443
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
15
06
2019
revised:
10
12
2019
accepted:
12
12
2019
pubmed:
27
12
2019
medline:
10
6
2021
entrez:
27
12
2019
Statut:
ppublish
Résumé
Exacerbation-prone asthma subtype has been reported in studies using data-driven methodologies. However, patterns of severe exacerbations have not been studied. To investigate longitudinal trajectories of severe wheeze exacerbations from infancy to school age. We applied longitudinal k-means clustering to derive exacerbation trajectories among 887 participants from a population-based birth cohort with severe wheeze exacerbations confirmed in healthcare records. We examined early-life risk factors of the derived trajectories, and their asthma-related outcomes and lung function in adolescence. 498/887 children (56%) had physician-confirmed wheeze by age 8 years, of whom 160 had at least one severe exacerbation. A two-cluster model provided the optimal solution for severe exacerbation trajectories among these 160 children: "Infrequent exacerbations (IE)" (n = 150, 93.7%) and "Early-onset frequent exacerbations (FE)" (n = 10, 6.3%). Shorter duration of breastfeeding was the strongest early-life risk factor for FE (weeks, median [IQR]: FE, 0 [0-1.75] vs. IE, 6 [0-20], P < .001). Specific airway resistance (sR We have identified two distinct trajectories of severe exacerbations during childhood with different early-life risk factors and asthma-related outcomes in adolescence.
Identifiants
pubmed: 31876035
doi: 10.1111/cea.13553
pmc: PMC7065181
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
315-324Subventions
Organisme : Medical Research Council
ID : MR/K002449/2
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_PC_13042
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S025340/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K002449/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0601361
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/K006665/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/LO12693/1
Pays : United Kingdom
Informations de copyright
© 2019 The Authors. Clinical & Experimental Allergy published by John Wiley & Sons Ltd.
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