TENOR risk score predicts healthcare in adults with severe or difficult-to-treat asthma
Open Access
- 1 December 2006
- journal article
- Published by European Respiratory Society (ERS) in European Respiratory Journal
- Vol. 28 (6), 1145-1155
- https://doi.org/10.1183/09031936.06.00145105
Abstract
The aim of the present study was to predict which patients with severe or difficult-to-treat asthma are at highest risk for healthcare utilisation can be predicted so as to optimise clinical management. Data were derived from 2,821 adults with asthma enrolled in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. Multiple potential predictors were assessed at baseline using a systematic algorithm employing stepwise logistic regression. Outcomes were asthma-related hospitalisations or emergency department (ED) visits within 6 months following baseline. Overall, 239 subjects (8.5%) reported hospitalisation or ED visits at follow-up. Predictors retained after multivariate analysis were as follows: younger age; female sex; non-white race; body mass index ≥35 kg·m-2; post-bronchodilator per cent predicted forced vital capacity <70%; history of pneumonia; diabetes; cataracts; intubation for asthma; and three or more steroid bursts in the prior 3 months. A final risk score derived from the logistic regression model ranged from 0–18 and was highly predictive (c-index: 0.78) of hospitalisation or ED visits. This tool was re-tested in a prospective validation using outcomes at 12- to 18-months follow-up among the same cohort (c-index: 0.77). The risk score derived is a clinically useful tool for assessing the likelihood of asthma-related hospitalisation or emergency department visits in adults with severe and difficult-to-treat asthma.Keywords
This publication has 16 references indexed in Scilit:
- Relationship of validated psychometric tools to subsequent medical utilization for asthmaJournal of Allergy and Clinical Immunology, 2005
- Sex Differences in Asthma Prevalence and Other Disease Characteristics in Eight StatesJournal of Asthma, 2005
- The global burden of asthma: executive summary of the GINA Dissemination Committee ReportAllergy, 2004
- Design and baseline characteristics of The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study: a large cohort of patients with severe or difficult-to-treat asthmaAnnals of Allergy, Asthma & Immunology, 2004
- Asthma Intervention Program Prevents Readmissions in High Healthcare UsersAmerican Journal of Respiratory and Critical Care Medicine, 2003
- Impact of a multidisciplinary day program on disease and healthcare costs in children and adolescents with severe asthma: A two‐year follow‐up studyPediatric Pulmonology, 2001
- Factors associated with hospital admissions and repeat emergency department visits for adults with asthmaThorax, 2000
- Markers of Risk of Asthma Death or Readmission in the 12 Months Following a Hospital Admission for AsthmaInternational Journal of Epidemiology, 1992
- An Economic Evaluation of Asthma in the United StatesThe New England Journal of Medicine, 1992
- Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials.Thorax, 1992