24912567 29283008 61096205 37993853 56275685 4294354 Fig 2 Frequency of all

24912567 29283008 61096205 37993853 56275685 4294354

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(24.91–25.67) (29.28–30.08) (61.09–62.05) (37.99–38.53) (56.27–56.85) (42.9–43.54) Fig. 2. Frequency of all signs and symptoms. Table 2. Five Most Frequent Signs and Symptoms Signs and Symptoms Pooled Proportion (95% CI) Nasal congestion 61.57 (61.09–62.05) Sleep disturbance 56.56 (56.27–56.85) Chest tightness 50.41 (50.18–50.64) Breathlessness 50.31 (50.11–50.51) Wheezing 46.97 (46.80–47.14) S IGNS AND S YMPTOMS IN A DULT A STHMA 256 R ESPIRATORY C ARE F EBRUARY 2020 V OL 65 N O 2
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regation was reported). Further, the combined utilization of inhaled and oral corticosteroids was 49.75% (95% CI 49.53–49.97) in 19 studies. Short- and long-acting ago- nists were administered to a pooled population of 63.32% (95% CI 62.99–63.35) and 64.79% (95% CI 64.32–65.26) in 8 and 4 studies, respectively. Severity of Symptoms or Disease Figure 5 presents the severity of asthma in the subjects included in our analysis. The highest proportion of sub- jects in our analysis were reported to have moderate to severe asthma (62.42% [95% CI 38.78–80.13%]), which was reported in 6 studies. Twelve studies included sub- jects with severe asthma, for which the pooled proportion was 26.17% (95% CI 16.55–37.11%). The pooled propor- tion of moderate and mild asthma were 20.64% (95% CI 10.62–32.95%) and 23.70% (95% CI 15.32–33.25%), re- spectively. In addition, some of the studies included in the analysis enrolled subjects with only moderate to severe asthma, so these results should be interpreted with caution. Combination of Symptoms and Asthma Severity Symptoms reported within a single study were presented as combinations. A total of 37 symptom combinations (defined as symptoms that exist concurrently in a subject) were reported in the included 67 studies (see the supple- mentary materials at ). We also calculated the average proportion of subjects affected by the different combinations of symptoms, the number of studies reporting the combination of symptoms, and the frequency of subjects with different severity of asthma (see the supplementary materials at - .com). In terms of prevalence, concurrent symptoms in- cluding wheezing, breathlessness, and bronchial hyper-re- sponsiveness (combination 35) affected the highest number of subjects ( n 11,297), followed by combination 17, in which subjects were affected by symptoms of wheezing, breathlessness, chest tightness, cough, sneezing, runny nose/rhinorrhea, sleep disturbances, bronchial hyper- responsiveness, and sinusitis ( n 6,590). The least prev- alent symptom combination was combination 20 (13.36%), which was a concurrent existence of wheezing, breathless- ness, chest tightness, cough, exercise-induced bronchoc- onstriction, sleep disturbances, asthma exacerbations, and bronchial hyper-responsiveness. A random-effects model (heterogeneity 100%, 2 0.6047, P 0.004) was used to determine the association between the combination of symptoms and the risk of asthma (Fig. 6). The risk of mild asthma was 0.78 (95% CI 0.57–1.08), History n / N Allergy/atopy Rhinitis Smoking Family history Past repiratory illness (other than asthma) Hospitilzation (due to asthma) Absence from work/school due to respiratory systems Occupational exposure Sinusitis 16,756/38,196 7,078/10,076 8,844/27,472 250/4,092 4,969/13,458 3,263/16,094 394/1,590 1,234/5,651 4,454/8,930 33 18 45 7 9 16 3 9 4 (63.37–63.69) (76.17–76.57) (44.96–45.26) (25.4–26.04) (42.55–43.19) (57.65–58.13) (35.12–36.2)
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