Factors associated with increased risk of exacerbations Poor asthma symptom control Any asthma exacerbation during the previous 12 months High SABA use (3 or more salbutamol canisters in a year, i.e. average of 1.6 actuations per day/11 actuations per week) Other concurrent chronic lung disease Poor lung function (even if few symptoms) Difficulty perceiving airflow limitation or the severity of exacerbations Eosinophilic airway inflammation (blood eosinophil count ≥300/microlitres despite maintenance treatment with medium-dose ICS) Exposure to cigarette smoke/vapes, smoke from fires Socioeconomic disadvantage Mental illness |
Factors associated with increased risk of life-threatening asthma History of severe exacerbation (intubation/ICU admission due to asthma [ever], 2 or more hospitalisations for asthma in past year, 3 or more ED visits for asthma in the past year, or hospitalisation or ED visit for asthma in the past month) History of sudden-onset acute asthma History of delayed presentation to acute care during moderate–severe exacerbation High SABA use (particularly if 12 or more salbutamol canisters/year, i.e. average 6.6 actuations per day) Comorbid cardiovascular disease Sensitivity and exposure to an unavoidable allergen (e.g. mould) Lack of written asthma action plan Social isolation Socioeconomic disadvantage Mental illness |
Factors associated with thunderstorm asthma Springtime allergic rhinitis or confirmed ryegrass pollen allergy (if exposed to high grass pollen levels during spring and early summer) |
Factors associated with accelerated decline in lung function Chronic hypersecretion of mucus Severe asthma exacerbation when not taking ICS Poor lung function Eosinophilic airway inflammation (blood eosinophil count ≥300/microlitres despite maintenance treatment with medium-dose ICS) Exposure to cigarette smoke Occupational asthma |
Factors associated with adverse effects of treatment Long-term high-dose ICS Frequent use of OCS |
Additional information
ED: emergency department; ICS: inhaled corticosteroids; SABA: short-acting beta2 agonist; OCS: oral corticosteroid