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The Darlington and Northallerton Long Term Asthma Study: pulmonary function

BioMed Central
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Abstract ral ss BioMed CentBMC Pulmonary Medicine Open AcceResearch article The Darlington and Northallerton Long Term Asthma Study: pulmonary function C Kevin Connolly*1 and Robin J Prescott2 Address: 1The Department of Medicine, The Memorial Hospital, Darlington, DL3 6HX, UK and 2Medical Statistics Unit, University of Edinburgh, Edinburgh, EH8 9AG, UK Email: C Kevin Connolly* - [email protected]; Robin J Prescott - [email protected] * Corresponding author Abstract Background: The Darlington and Northallerton Asthma Study is an observational cohort study started in 1983. At that time little was published about long term outcome in asthma and the contribution of change in reversible disease or airway remodelling to any excess deterioration in function. The study design included regular review of overall and fixed function lung. We report the trends over fifteen years. Methods: All asthmatics attending secondary care in 1983, 1988 and 1993 were recruited. Pulmonary function was recorded at attendance and potential best function estimated according to protocol. Rate of decline was calculated over each 5-year period and by linear regression analysis in those seen every time. The influence of potential explanatory variables on this decline was explored. Results: 1724 satisfactory 5-year measurements were obtained in 912 subjects and in 200 subjects on all occasions. Overall rate of decline (ml/year (95%CI)) calculated from 5-year periods was FEV1 �41.0 (34.7–47.3), �28.9 (23.2–34.6) and best FVC �63.1 (55.1–71.2)ml/year, �45.8 (40.0– 51.6).The principal association was with age. A dominant cubic factor suggested fluctuations in the rate of change in middle life with less rapid decline in youth and more rapid decline in the elderly. Rapid decline was possibly associated with short duration. Treatment step did not predict rate of deterioration. Conclusions: Function declined non-linearly and more rapidly than predicted from normal subjects. It repor

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