Cargando…

Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma

PURPOSE: Aspirin-exacerbated respiratory disease (AERD) has attracted a great deal of attention because of its association with increased asthma severity. However, oral aspirin challenge (OAC) to diagnose AERD is a time-consuming procedure, and some patients experience serious complications. Thus, w...

Descripción completa

Detalles Bibliográficos
Autores principales: Chang, Hun Soo, Park, Jong-Sook, Jang, An-Soo, Park, Sung-Woo, Uh, Soo-Taek, Kim, Young Hoon, Park, Choon-Sik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178824/
https://www.ncbi.nlm.nih.gov/pubmed/21966606
http://dx.doi.org/10.4168/aair.2011.3.4.256
_version_ 1782212443884224512
author Chang, Hun Soo
Park, Jong-Sook
Jang, An-Soo
Park, Sung-Woo
Uh, Soo-Taek
Kim, Young Hoon
Park, Choon-Sik
author_facet Chang, Hun Soo
Park, Jong-Sook
Jang, An-Soo
Park, Sung-Woo
Uh, Soo-Taek
Kim, Young Hoon
Park, Choon-Sik
author_sort Chang, Hun Soo
collection PubMed
description PURPOSE: Aspirin-exacerbated respiratory disease (AERD) has attracted a great deal of attention because of its association with increased asthma severity. However, oral aspirin challenge (OAC) to diagnose AERD is a time-consuming procedure, and some patients experience serious complications. Thus, we evaluated diagnostic values of non-invasive clinical parameters to predict AERD in asthmatic patients. METHODS: A total of 836 Korean subjects were recruited from an asthma cohort. They underwent OAC, and clinical parameters including the history of aspirin hypersensitivity, nasal polyposis, and chronic sinusitis of aspirin-tolerant asthma (ATA) and AERD asthmatic patients were compared. RESULTS: Significant differences (P<0.01) were found in eight parameters: age at diagnosis, body mass index, FEV1%, PC20, history of urticaria, nasal polyps, chronic sinusitis, and history of aspirin hypersensitivity. After logistic regression analysis based on the eight clinical parameters, nasal polyps, history of aspirin intolerance, sinusitis, and log [PC20 methacholine] remained significantly associated with AERD (P<0.05). The sensitivity and specificity of the history of aspirin hypersensitivity to predict AERD were 64.7% and 92.0%, respectively, and the positive and negative predictive values were 56.9% and 94.1%, respectively. Overall, the accuracy of the test was 88.2%. The accuracy of the tests for nasal polyps and chronic sinusitis were 67.3% and 60.4%, respectively. CONCLUSIONS: Among clinical parameters associated with AERD, the history of aspirin hypersensitivity has the best positive and negative predictive values for the oral aspirin challenge test. Because the false-positive and -negative rates were still high, additional non-invasive methods are needed to reduce the rate of false outcomes.
format Online
Article
Text
id pubmed-3178824
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease
record_format MEDLINE/PubMed
spelling pubmed-31788242011-10-01 Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma Chang, Hun Soo Park, Jong-Sook Jang, An-Soo Park, Sung-Woo Uh, Soo-Taek Kim, Young Hoon Park, Choon-Sik Allergy Asthma Immunol Res Original Article PURPOSE: Aspirin-exacerbated respiratory disease (AERD) has attracted a great deal of attention because of its association with increased asthma severity. However, oral aspirin challenge (OAC) to diagnose AERD is a time-consuming procedure, and some patients experience serious complications. Thus, we evaluated diagnostic values of non-invasive clinical parameters to predict AERD in asthmatic patients. METHODS: A total of 836 Korean subjects were recruited from an asthma cohort. They underwent OAC, and clinical parameters including the history of aspirin hypersensitivity, nasal polyposis, and chronic sinusitis of aspirin-tolerant asthma (ATA) and AERD asthmatic patients were compared. RESULTS: Significant differences (P<0.01) were found in eight parameters: age at diagnosis, body mass index, FEV1%, PC20, history of urticaria, nasal polyps, chronic sinusitis, and history of aspirin hypersensitivity. After logistic regression analysis based on the eight clinical parameters, nasal polyps, history of aspirin intolerance, sinusitis, and log [PC20 methacholine] remained significantly associated with AERD (P<0.05). The sensitivity and specificity of the history of aspirin hypersensitivity to predict AERD were 64.7% and 92.0%, respectively, and the positive and negative predictive values were 56.9% and 94.1%, respectively. Overall, the accuracy of the test was 88.2%. The accuracy of the tests for nasal polyps and chronic sinusitis were 67.3% and 60.4%, respectively. CONCLUSIONS: Among clinical parameters associated with AERD, the history of aspirin hypersensitivity has the best positive and negative predictive values for the oral aspirin challenge test. Because the false-positive and -negative rates were still high, additional non-invasive methods are needed to reduce the rate of false outcomes. The Korean Academy of Asthma, Allergy and Clinical Immunology; The Korean Academy of Pediatric Allergy and Respiratory Disease 2011-10 2011-07-01 /pmc/articles/PMC3178824/ /pubmed/21966606 http://dx.doi.org/10.4168/aair.2011.3.4.256 Text en Copyright © 2011 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chang, Hun Soo
Park, Jong-Sook
Jang, An-Soo
Park, Sung-Woo
Uh, Soo-Taek
Kim, Young Hoon
Park, Choon-Sik
Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma
title Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma
title_full Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma
title_fullStr Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma
title_full_unstemmed Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma
title_short Diagnostic Value of Clinical Parameters in the Prediction of Aspirin-Exacerbated Respiratory Disease in Asthma
title_sort diagnostic value of clinical parameters in the prediction of aspirin-exacerbated respiratory disease in asthma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178824/
https://www.ncbi.nlm.nih.gov/pubmed/21966606
http://dx.doi.org/10.4168/aair.2011.3.4.256
work_keys_str_mv AT changhunsoo diagnosticvalueofclinicalparametersinthepredictionofaspirinexacerbatedrespiratorydiseaseinasthma
AT parkjongsook diagnosticvalueofclinicalparametersinthepredictionofaspirinexacerbatedrespiratorydiseaseinasthma
AT jangansoo diagnosticvalueofclinicalparametersinthepredictionofaspirinexacerbatedrespiratorydiseaseinasthma
AT parksungwoo diagnosticvalueofclinicalparametersinthepredictionofaspirinexacerbatedrespiratorydiseaseinasthma
AT uhsootaek diagnosticvalueofclinicalparametersinthepredictionofaspirinexacerbatedrespiratorydiseaseinasthma
AT kimyounghoon diagnosticvalueofclinicalparametersinthepredictionofaspirinexacerbatedrespiratorydiseaseinasthma
AT parkchoonsik diagnosticvalueofclinicalparametersinthepredictionofaspirinexacerbatedrespiratorydiseaseinasthma