Observational studyBMJ open2018
Risk factors of asthma exacerbation based on asthma severity: a nationwide population-based observational study in South Korea.
Observational study in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Asthmatic patients with vitamin D deficiency: Can vitamin D supplementation make a difference.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024Pooled it
- The nationwide retrospective cohort study by Health Insurance Review and Assessment Service proves that asthma management decreases the exacerbation risk of asthma.Scientific reports · 2021Trial
- Impact of comorbid asthma on severity of coronavirus disease (COVID-19).Scientific reports · 2020Trial
- Exacerbation-prone asthma in the context of race and ancestry in Asthma Clinical Research Network trials.The Journal of allergy and clinical immunology · 2019Trial
- Association of Tirzepatide versus Semaglutide with Risk of Asthma Exacerbation in Patients with Asthma and Type 2 Diabetes: A US Multicenter Retrospective Cohort Study.Journal of asthma and allergy · 2026Article
- Change in Exacerbation Rate of Asthma Patients before and after COVID-19 Infection.Tuberculosis and respiratory diseases · 2025Article
- Association between income, employment status, and asthma outcomes: a systematic review and meta-analysis.The Lancet regional health. Europe · 2025Article
- Incidence, risk factors, and outcomes of respiratory related hospitalizations in older patients with COPD, asthma, and bronchiectasis.Scientific reports · 2025Article
- Clinical and Pathophysiological Tangles Between Allergy and Autoimmunity: Deconstructing an Old Dichotomic Paradigm.Clinical reviews in allergy & immunology · 2025Review
- Association between heated tobacco product use and worsening asthma symptoms: findings from a nationwide internet survey in Japan, 2023.Environmental health and preventive medicine · 2025Article
- Risk Factors for Acute Asthma Exacerbations in Adults With Mild Asthma.The journal of allergy and clinical immunology. In practice · 2024Article
- Incident Asthma, Asthma Exacerbations, and Asthma-Related Hospitalizations in Patients With Atopic Dermatitis.The journal of allergy and clinical immunology. In practice · 2024Article
- Adherence to treatment guidelines and good asthma control in Finland.European clinical respiratory journal · 2023Article
- Article
- Association of comorbidities and medications with risk of asthma exacerbation in pediatric patients: a retrospective study using Japanese claims data.Scientific reports · 2022Article
- Determining Persistence with an Inhaled Corticosteroid in Asthma: Assessment Using an Objective Measurement vs the Self-Reported Foster Score.Journal of asthma and allergy · 2022Article
- A nationwide survey of the association between nonalcoholic fatty liver disease and the incidence of asthma in Korean adults.PloS one · 2022Article
- Article
- Does the Use of Asthma-Controller Medication in Accordance with Guidelines Reduce the Incidence of Acute Exacerbations and Healthcare Costs?Tuberculosis and respiratory diseases · 2022Article
- Association Between Medication Adherence and Risk of COPD in Adult Asthma Patients: A Retrospective Cohort Study in Canada.Clinical epidemiology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAsthma exacerbation, associated with many risks factors, can reflect management failure. However, little is known about how risk factors are associated with exacerbation, according to asthma severity. We aimed to investigate differences in risk factors in patients with different asthma severity and evaluate whether risk factors differed between frequent exacerbators and patients with single exacerbation.
designNationwide population-based observational study.
settingKorean National Sample Cohort database.
participantsWe included 22 130 adults with asthma diagnoses more than twice (ICD-10 (International Classification of Diseases, Tenth revision) codes J45 and J46) and one prescription for asthma medication from 2010 to 2011. OUTCOME MEASURES: Asthma exacerbation was defined as having a corticosteroid (CS) burst characterised by a prescription of high-dose oral CS for ≥3 days or one systemic CS injection, hospitalisation or emergency department visit.
resultsAmong severities, history of CS bursts was significantly associated with exacerbation. In mild and moderate asthma, exacerbation was significantly associated with age ≥45 years, being female, gastro-oesophageal reflux disease and chronic rhinitis. High medication possession ratio (MPR≥50%), compared with low MPR (<20%) showed adjusted ORs of 0.828 (95% CI 0.707 to 0.971) and 0.362 (0.185 to 0.708) in moderate and severe asthma, respectively. In severe asthma, compared with mild asthma, only allergic rhinitis and history of hospitalisation were strongly associated with exacerbation. When comparing frequent exacerbators to patients with single exacerbation, age ≥45 years, atopic dermatitis, anxiety and history of CS burst were significant risk factors in mild and moderate asthma, whereas no risk factors were significant in severe asthma.
conclusionsDifferent associations between risk factors and asthma exacerbations based on asthma severity suggest that patients with mild asthma require greater attention to their age and comorbidities, whereas those with severe asthma require greater attention to hospitalisation history and drug adherence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.