Comorbidities in difficult asthma are independent risk factors for frequent exacerbations, poor control and diminished quality of life

• DOI: 10.1111/resp.12838
• Publication Date: 2016-07-01T01:13:07Z
• Authors: Tunn Ren Tay; Naghmeh Radhakrishna; Fiona Hore‐Lacy; Catherine Smith; Ryan Hoy; Eli Dabscheck; Mark Hew
• Keywords: Adult; Male; Depression; Statistics as Topic; Australia; 610; Comorbidity; Middle Aged; Rhinitis, Allergic; Risk Assessment; Severity of Illness Index; Asthma; 3. Good health; Body Mass Index; 03 medical and health sciences; Sleep Apnea Syndromes; 0302 clinical medicine; Risk Factors; 616; Outcome Assessment, Health Care; Gastroesophageal Reflux; Quality of Life; Humans; Female; Aged

Little is known about how comorbidities affect difficult asthma patients across different domains of outcomes. We hypothesized that in significantly influence outcomes.We analysed 90 consecutive who underwent systematic assessment at our hospital's clinic. Eight were assessed all patients. They allergic rhinitis, chronic rhinosinusitis (CRS), gastroesophageal reflux disease, obesity, obstructive sleep apnoea, anxiety or depression, dysfunctional breathing (DB) and vocal cord dysfunction (VCD). Asthma outcomes examined exacerbation frequency (≥3/year vs <3/year), control using the Control Test (ACT) quality life Quality Life Questionnaire (AQLQ). Multivariate logistic regression was performed for dichotomous linear continuous Analyses adjusted lung function absolute blood eosinophils.Increasing BMI an independent risk factor exacerbations (OR: 1.1, 95% CI: 1-1.1, P = 0.042), lower ACT score (β coefficient: -0.25, -0.37 to -0.12, < 0.001) poorer AQLQ -0.05, -0.09 -0.02, 0.006). DB predicted -2.85, -5 -0.7, 0.01) scores -0.73, -1.34 0.02). Patients with CRS had more 4, 1.5-10.9, VCD -0.78, -1.38 -0.18, 0.012).Comorbidities independently impact a broad spectrum asthma. Systematic evaluation these conditions essential