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Clinical Implications of Having Reduced Mid Forced Expiratory Flow Rates , Independently of FEV1, in Adult Patients with Asthma
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Clinical Implications of Having Reduced Mid Forced Expiratory Flow Rates , Independently of FEV1, in Adult Patients with Asthma
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Clinical Implications of Having Reduced Mid Forced Expiratory Flow Rates , Independently of FEV1, in Adult Patients with Asthma
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Journal Article
Clinical Implications of Having Reduced Mid Forced Expiratory Flow Rates , Independently of FEV1, in Adult Patients with Asthma
2015
Overview
FEF.sub.25-75 is one of the standard results provided in spirometry reports; however, in adult asthmatics there is limited information on how this physiological measure relates to clinical or biological outcomes independently of the FEV.sub.1 or the FEV.sub.1 /FVC ratio. To determine the association between Hankinson's percent-predicted FEF.sub.25-75 (FEF.sub.25-75 %) levels with changes in healthcare utilization, respiratory symptom frequency, and biomarkers of distal airway inflammation. In participants enrolled in the Severe Asthma Research Program 1-2, we compared outcomes across FEF.sub.25-75 % quartiles. Multivariable analyses were done to avoid confounding by demographic characteristics, FEV.sub.1, and the FEV.sub.1 /FVC ratio. In a sensitivity analysis, we also compared outcomes across participants with FEF.sub.25-75 % below the lower limit of normal (LLN) and FEV.sub.1 /FVC above LLN. Subjects in the lowest FEF.sub.25-75 % quartile had greater rates of healthcare utilization and higher exhaled nitric oxide and sputum eosinophils. In multivariable analysis, being in the lowest FEF.sub.25-75 % quartile remained significantly associated with nocturnal symptoms (OR 3.0 [95%CI 1.3-6.9]), persistent symptoms (OR 3.3 [95%CI 1-11], ICU admission for asthma (3.7 [1.3-10.8]) and blood eosinophil % (0.18 [0.07, 0.29]). In the sensitivity analysis, those with FEF.sub.25-75 %
Publisher
Public Library of Science
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