The association between impulse oscillometry Z-scores and asthma control and exacerbation risk in a tertiary severe asthma clinic
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Abstract
Introduction: Respiratory oscillometry is a sensitive measure of small airways dysfunction. Limited evidence regarding cutoff values for interpretation represents a barrier to clinical use. The aims of this study were to determine if the presence and severity of abnormality as defined by Z-scores for oscillometric parameters are associated with asthma symptoms and exacerbations. Methods: We retrospectively reviewed the medical records of all patients with asthma managed in a severe asthma clinic from 2019 to 2022 who underwent routine oscillometry. Z-scores for oscillometric parameters were analyzed as continuous and categorical variables to assess associations with asthma control and exacerbation risk. Results: When analyzed as categorical variables, Z-scores that define severity for resistance (R5), reactance (X5) and area under the reactance curve (AX) were related to the level of asthma control (ACQ5). Z-scores also correlated with worst asthma control (ACQ5 and ACT) on continuous variable analysis (P < 0.005). These correlations remained significant after adjusting for spirometry, FeNO and treatment changes. Elevated Z-scores (> 1.64) for R5 was associated with higher risk of exacerbations (OR 2.70, 95%CI 1.27 to 5.17, P = 0.009). The exacerbation risk increased with the severity of airway obstruction. Similar but non-significant associations were observed for AX and X5 and exacerbation risk. Discussion: The presence and severity of airway obstruction as defined by R5 Z-scores predicts poor asthma control and increased exacerbation risk. Equivalent associations with asthma control were observed for X5 and AX Z-scores. Clinicians should use Z-scores in preference to other cutoffs to aid interpretation.
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imported_1768911358_696f71fe68af8
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| Authors | King, Gregory |
| Journal | Frontiers in surgery |
| Year | Year not found |
| DOI |
10.3389/falgy.2026.1741154
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| Keywords | Keywords not found |
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