Asma Chaudhry, Kaleem Ullah Toori, Sumaira Saleem.
Frequency and risk factors of frequent exacerbations of asthma in patients in a tertiary care hospital: a hospital-based comparative study.
Pak Armed Forces Med J Jan ;68(2):207-13.

Objective: To determine the frequency of recurrent exacerbations in asthma patients and compare the risk factors for frequent and non frequent exacerbations. Study Design: Cross-sectional study. Place and Duration of Study: KRL Hospital Islamabad from Jun to Dec 2016. Patients and Methods: Non-probability technique was used to sample two hundred and eighty one patients.Asthma exacerbations were defined by GINA guidelines. Frequent exacerbations were defined as two or more in the previous year. Data regarding demographics and risk factors were collected. Inhaler technique was checked.BMI and blood eosinophil levels were measured. SPSS 22 was used for data analysis. Results: Out of total 281 patients, frequent asthma exacerbations were observed in 143 (50.9%) patients. Female gender (p=0.00) and lower education (p=0.02) led to frequent exacerbations. Patients education about disease or treatment (p=0.03), URTI (p=0.00), allergen exposure (p=0.00), drug history (p=0.04), treatment step-II (p=0.00), medication non-compliance (p=0.00), incorrect inhaler technique (p=0.01), anxiety (p=0.01), previous ICU admission (p=0.02) and blood eosinophilia (p=0.00) were significantly associated with frequent exacerbations. Of these, independent predictors were patient education (p=0.02), URTI (p=0.00), allergen exposure (p=0.00), drug history (p=0.00), treatment step-II (p=0.03), medication non-compliance (p=0.02), anxiety (p=0.01) and eosinophilia (p=0.00). Conclusion: Majority of our patients underwent frequent exacerbations. Risk factors found to be associated with frequent exacerbations were female gender, lower education, patient unawareness, URTI, allergen and drug exposure, treatment step-II, medication non-compliance, anxiety and blood eosinophilia.

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