Recovery patterns of pulmonary function after acute asthma exacerbation in children: a prospective study using time-to-event analysis

OBJECTIVE: Recovery of pulmonary function following acute asthma exacerbations varies considerably among pediatric patients, and factors associated with delayed recovery remain poorly understood. This prospective study aimed to determine the time to pulmonary function recovery using a time-to-event approach and to identify clinical factors associated with delayed recovery in children with moderate-to-severe asthma exacerbations. METHODS: Forty-two children admitted with a diagnosis of a moderate-to-severe asthma attack to our hospital were included in this prospective study. The demographics and asthma clinical characteristics of the patients were recorded. After the initial asthma attack treatment pulmonary function tests were performed on days 1, 5, 14, and 28. Recovery was defined as the time to reach the highest predicted FEV1% during follow-up. RESULTS: % (adjusted HR 1.004, 95% CI 0.981-1.029) and exacerbation severity (adjusted HR 0.924, 95% CI 0.351-2.430) were not significantly associated with recovery time. CONCLUSION: Pulmonary function recovery following pediatric asthma exacerbations generally occurred within two weeks but extended to four weeks in a considerable proportion of patients. We did not identify statistically significant clinical predictors of recovery duration; however, modest associations cannot be excluded because of the limited sample size. These findings support individualized follow-up after asthma exacerbations and highlight the need for larger prospective studies investigating biological and clinical determinants of pulmonary function recovery.