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Classification of Asthma Severity (Children 0-4 years of age)

Classification of Asthma Severity (Children 5-11 years of age)

Classification of asthma severity (Youth ≥12 years of age and adults)

Classification of asthma severity in children 0-4 years of age

Abbreviations:
EIB = exercise-induced bronchospasm
FEV1 = forced expiratory volume in 1 second
FVC = forced vital capacity

Components of severity Intermittent Persistent
Mild Moderate Severe
Impairment Symptoms ≤2 days/week >2 days/week, but not daily Daily Throughout the day
Nighttime awakenings 0 1-2x/month 3-4x/month >1x/week
Short-acting beta2-agonist use for symptom control (not prevention of EIB) ≤2 days/week >2 days/week, but not daily Daily Several times per day
Interference with normal activity None Minor limitation Some limitation Extremely limited
Risk Exacerbations requiring oral systemic corticosteroids 0-1/year ≥2 exacerbations in 6 months requiring oral steroids, or ≥4 wheezing episodes/1 year lasting >1 day AND risk factors for persistent asthma
Consider severity and interval since last exacerbation. Frequency and severity may fluctuate over time.
Exacerbations of any severity may occur in patients in any severity category

Classification of asthma severity in children 5-11 years of age

Abbreviations:
EIB = exercise-induced bronchospasm
FEV1 = forced expiratory volume in 1 second
FVC = forced vital capacity

Components of severity Intermittent Persistent
Mild Moderate Severe
Impairment Symptoms ≤2 days/week >2 days/week, but not daily Daily Throughout the day
Nighttime awakenings ≤2x/month 3-4x/month >1x/week, but not nightly Often 7x/week
Short-acting beta2-agonist use for symptom control (not prevention of EIB) ≤2 days/week >2 days/week, but not daily Daily Several times per day
Interference with normal activity None Minor limitation Some limitation Extremely limited
Lung function Normal FEV1between exacerbations FEV1>80% predicted FEV1/FVC >85% FEV1= >80% predicted FEV1/FVC >80% FEV1= 60-80% predicted FEV1/FVC 75-80% FEV1= <60% predicted FEV1/FVC <75%
Risk Exacerbations requiring oral systemic corticosteroids 0-1/year ≥2 in 1 year
Consider severity and interval since last exacerbation. Frequency and severity may fluctuate over time for patients in any severity category.
Relative annual risk of exacerbations may be related to FEV1

Classification of asthma severity in youth ≥12 years of age and adults

Abbreviations:
EIB = exercise-induced bronchospasm
FEV1 = forced expiratory volume in 1 second
FVC = forced vital capacity

Components of severity Intermittent Persistent
Mild Moderate Severe
Impairment Symptoms ≤2 days/week >2 days/week, but not daily Daily Throughout the day
Nighttime awakenings ≤2x/month 3-4x/month >1x/week, but not nightly Often 7x/week
Short-acting beta2-agonist use for symptom control (not prevention of EIB) ≤2 days/week >2 days/week, but not daily Daily Several times per day
Interference with normal activity None Minor limitation Some limitation Extremely limited
Lung function Normal FEV1between exacerbations FEV1>80% predicted FEV1/FVC normal FEV1≥80% predicted FEV1/FVC normal FEV1>60% but <80% predicted FEV1/FVC reduced 5% FEV1= <60% predicted FEV1/FVC reduced 5%
Risk Exacerbations requiring oral systemic corticosteroids 0-1/year ≥2 in 1 year
Consider severity and interval since last exacerbation. Frequency and severity may fluctuate over time for patients in any severity category.
Relative annual risk of exacerbations may be related to FEV1

 

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