社区的重症哮喘与非重症哮喘：一项大型电子数据库分析研究
2017/08/08
摘要
背景：根据2014国际指南和医疗保健利用, 在351799人的社区进行了一次大型电子数据库分析, 年龄为20-70 岁, 以确定重症哮喘的患病率和临床特点。
方法：重症哮喘患者被分为可控性重症哮喘和不可控性重症哮喘，不可控性重症哮喘根据用药不同分为不同亚组。同一年龄的非哮喘人群作为对照组。
结果:受试者中共有19991人（5.68%）被诊断为哮喘，其中重症哮喘占4.65%。这些人群中，1/3为不可控性重症哮喘。可控性重症哮喘组和非重症哮喘组、非哮喘组在急诊室就诊率 (分别为21.5%、22% 和 20%) 和所有原因引起的住院率 (分别为7.4%、7.4% 和 6.4%) 相似。不可控性重症哮喘组较可控性重症哮喘有较高的住院率（RR=2.9）。不可控性哮喘组中只有19.2%的重症哮喘患者进行IgE检测，3.6%使用了奥马珠单抗。
结论：重症哮喘患者在所有哮喘患者中不到5%。控制重症哮喘在降低医疗保健利用中至关重要。一项简单的根据药物使用情况的电子数据库分析可以帮助医生确定需要重点努力的不可控性重症哮喘患者的亚组。
Severe and non-severe asthma in the community: A large electronic database analysis.
Varsano S1, Segev D2, Shitrit D3
Abstract
BACKGROUND: A large electronic database analysis was conducted in a community of 351,799 people, ages 20-70 years to determine the prevalence and clinical characteristics of severe asthma, according to 2014 international guidelines and healthcare utilization.
METHODS: Severe asthmatics were grouped into controlled severe-asthma and uncontrolled severe-asthma and additional subgroups of uncontrolled severe asthma on the basis of medications dispensed. Non-asthmatic population at the same ages served as controls.
RESULTS: A total of 19,991 (5.68%) were diagnosed as asthmatic, of which 4.65% had severe asthma. Of these, one-third was uncontrolled severe-asthma. Controlled severe-asthma group was similar to non-severe asthma and non-asthmatics in the rate of emergency room visits (21.5%, 22%, and 20%, respectively) and to all cause hospitalizations (7.4%, 7.4%, and 6.4%, respectively). Uncontrolled severe-asthmatics had significantly more hospitalizations (RR = 2.9) than controlled severe-asthmatics. Only 19.2% of uncontrolled-severe asthmatics had IgE testing and 3.6% were dispensed omalizumab.
CONCLUSIONS: The prevalence of severe asthma is slightly less than 5% of all asthmatics. Controlling severe asthma is crucial to reducing healthcare utilization. A simple electronic database analysis, based on dispensed medications, can help healthcare providers identify subgroups of uncontrolled severe asthmatics that require focused efforts.
背景：根据2014国际指南和医疗保健利用, 在351799人的社区进行了一次大型电子数据库分析, 年龄为20-70 岁, 以确定重症哮喘的患病率和临床特点。
方法：重症哮喘患者被分为可控性重症哮喘和不可控性重症哮喘，不可控性重症哮喘根据用药不同分为不同亚组。同一年龄的非哮喘人群作为对照组。
结果:受试者中共有19991人（5.68%）被诊断为哮喘，其中重症哮喘占4.65%。这些人群中，1/3为不可控性重症哮喘。可控性重症哮喘组和非重症哮喘组、非哮喘组在急诊室就诊率 (分别为21.5%、22% 和 20%) 和所有原因引起的住院率 (分别为7.4%、7.4% 和 6.4%) 相似。不可控性重症哮喘组较可控性重症哮喘有较高的住院率（RR=2.9）。不可控性哮喘组中只有19.2%的重症哮喘患者进行IgE检测，3.6%使用了奥马珠单抗。
结论：重症哮喘患者在所有哮喘患者中不到5%。控制重症哮喘在降低医疗保健利用中至关重要。一项简单的根据药物使用情况的电子数据库分析可以帮助医生确定需要重点努力的不可控性重症哮喘患者的亚组。
(中日友好医院呼吸与危重症医学科 王瑞茵 摘译 林江涛 审校)
(Respir Med. 2017 Feb;123:131-139. doi: 10.1016/j.rmed.2016.12.017. Epub 2016 Dec 28)
(Respir Med. 2017 Feb;123:131-139. doi: 10.1016/j.rmed.2016.12.017. Epub 2016 Dec 28)
Severe and non-severe asthma in the community: A large electronic database analysis.
Varsano S1, Segev D2, Shitrit D3
Abstract
BACKGROUND: A large electronic database analysis was conducted in a community of 351,799 people, ages 20-70 years to determine the prevalence and clinical characteristics of severe asthma, according to 2014 international guidelines and healthcare utilization.
METHODS: Severe asthmatics were grouped into controlled severe-asthma and uncontrolled severe-asthma and additional subgroups of uncontrolled severe asthma on the basis of medications dispensed. Non-asthmatic population at the same ages served as controls.
RESULTS: A total of 19,991 (5.68%) were diagnosed as asthmatic, of which 4.65% had severe asthma. Of these, one-third was uncontrolled severe-asthma. Controlled severe-asthma group was similar to non-severe asthma and non-asthmatics in the rate of emergency room visits (21.5%, 22%, and 20%, respectively) and to all cause hospitalizations (7.4%, 7.4%, and 6.4%, respectively). Uncontrolled severe-asthmatics had significantly more hospitalizations (RR = 2.9) than controlled severe-asthmatics. Only 19.2% of uncontrolled-severe asthmatics had IgE testing and 3.6% were dispensed omalizumab.
CONCLUSIONS: The prevalence of severe asthma is slightly less than 5% of all asthmatics. Controlling severe asthma is crucial to reducing healthcare utilization. A simple electronic database analysis, based on dispensed medications, can help healthcare providers identify subgroups of uncontrolled severe asthmatics that require focused efforts.
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重症哮喘研究计划（SARP III）队列的基线特征：差异与年龄
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COPD患者急性加重的频率：对COPD亚人群中期结果分析（SPIROMICS）的队列研究
