Objective

Patients seeking treatment for their asthma are most likely motivated by a change in their experience of symptoms, but primary complaints are not always related to the pulmonary system. This study aimed to determine the frequency of such extrapulmonary symptoms in asthma outpatients and their association with psychopathology and asthma outcomes.

Methods

This cross-sectional study utilized data collected as part of a nationwide, clinical-epidemiological study. The final sample of 572 asthma patients represented all levels of asthma control and severity. Information on demographics and respiratory function was obtained from physicians' documentation. Symptoms were explored using a standardized checklist.

Results

Primary symptoms reported by asthma patients were not necessarily airway-related. Patients reported feeling at least occasionally “tired” (72.1%) and “exhausted” (66.8%) more than any other asthma symptom. Hyperventilation and mood symptoms were experienced by 34.4–42.6% of patients. Anxiety or depression diagnoses indicated higher scores in all symptom domains. Controlling for asthma-related factors and psychopathology, fatigue had a small but significant effect on both asthma-related quality of life (AQLQ) (r_sp² = 0.02, P < .001) and asthma control (r_sp² = 0.01, P = .003). Mood symptoms also showed a small but significant effect on AQLQ (r_sp² = 0.02, P < .001).

Conclusion

Findings suggest that extrapulmonary symptoms are endorsed more frequently than previously reported. Symptoms nonspecific to asthma can play a substantial role in clinical presentation and exclusive focus on airway symptoms may miss important information related to patients' well-being. Surveillance of extrapulmonary symptoms alongside pulmonary function is warranted for an integrated medicine approach to asthma management.

中文翻译：

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在专科肺部护理中治疗的哮喘患者的肺外症状

客观的

寻求哮喘治疗的患者最有可能是因为他们的症状经历发生了变化，但主诉并不总是与肺系统有关。本研究旨在确定哮喘门诊患者出现此类肺外症状的频率及其与精神病理学和哮喘结果的关联。

方法

这项横断面研究利用收集的数据作为全国性临床流行病学研究的一部分。572 名哮喘患者的最终样本代表了哮喘控制和严重程度的所有水平。关于人口统计学和呼吸功能的信息是从医生的文件中获得的。使用标准化检查表探索症状。

结果

哮喘患者报告的主要症状不一定与气道有关。与任何其他哮喘症状相比，患者报告至少偶尔会感到“疲倦”（72.1%）和“筋疲力尽”（66.8%）。34.4-42.6% 的患者出现换气过度和情绪症状。焦虑或抑郁的诊断表明在所有症状领域都有更高的分数。控制哮喘相关因素和精神病理学，疲劳对哮喘相关生活质量 (AQLQ) ( r _sp ²  = 0.02, P  < .001) 和哮喘控制 ( r _sp ²  = 0.01, P  = .003）。情绪症状也对 AQLQ ( r _sp ² = 0.02，P  < .001）。

结论

研究结果表明，肺外症状比以前报告的更频繁。哮喘非特异性症状可能在临床表现中发挥重要作用，仅关注气道症状可能会错过与患者健康相关的重要信息。对于哮喘管理的综合医学方法，有必要对肺外症状和肺功能进行监测。