Asthma - Description

Page Contents

• Other Names
• ICD-9
• Description
• Genetics
• Prognosis
• Prevalence
• Impact
• Pearls And Alerts

Other Names

Reactive airways disease

ICD-9

493, Asthma

Asthma is coded with 493 plus a fourth and, in some cases, a fifth digit indicating type of asthma (e.g., 493.1 - intrinsic asthma, 493.81 - exercise induced asthma). Click Asthma ICD9 ( 52 KB) for more detail and for coding of related conditions and complications.

Description

Asthma is a complex, recurrent disease of the airways that causes shortness of breath, wheezing, and cough (particularly at night or early in the morning). Asthma is episodic in nature and usually reversible, either spontaneously or with treatment. However, chronic inflammation, associated with persistent symptoms, may contribute to airway remodeling that may not be completely reversible. Airflow limitation occurs as a result of varying degrees of airway hyperresponsiveness, airway edema, and bronchoconstriction. [National: 2007] Asthma symptoms are often "triggered" by: environmental stimuli (smoke, perfumes, dust mites, animals, fungi/molds, cold air) and aggravating conditions (viral upper respiratory infections or URIs, rhinitis, sinusitis, gastroesophageal reflux, stress, exercise). Such triggers may be more important for some asthma phenotypes than others. Research is beginning to identify specific patterns of inflammation and treatment response in asthma phenotypes (see Asthma, Causes).

Genetics

Asthma is one of three atopic conditions (asthma, hay fever, eczema) that appear to result from a combination of environmental and genetic factors (see Asthma, Causes).

Prognosis

Approximately 1/3 of children with asthma will "outgrow" the condition by the time they are adults and these children tend to be those with milder asthma symptoms. Children who develop asthma after age 5 are less likely than those who did so before age 3 to have long-term residual effects. Although there is a risk of severe disease and death with asthma, this is increasingly unusual and the majority of children with appropriately treated asthma function as well as those without asthma. There is still much room for improvement however, particularly among minority populations. [National: 2007]

Prevalence

National Heart, Lung, and Blood Institute (NHLBI) Guidelines for the Diagnosis and Management of Asthma [National: 2007], published in 2007, estimate that 6 million children in the U.S. have asthma. In 2006, in children 0 to 17 years of age, the prevalence of asthma was 7.5% in males and 5.5% in females [Utah: 2007], although, in other age groups, asthma is more prevalent in females ([Akinbami: 2006]. In Utah, 11.5% of children whose families have annual income levels less than $20,000 have asthma. [Utah: 2007]

Impact

Asthma, especially if uncontrolled, is expensive in both direct and indirect costs. [Lenney: 1997] [Mielck: 1996] Annual US costs of treating pediatric asthma are estimated to be $1.9 billion, including: over 8.7 million prescriptions, 3,537,000 doctor visits, 658,000 emergency department visits, and 190,000 hospitalizations. Annual indirect costs of asthma include: 60% of school absences (children with severe asthma may miss >30 school days per year) and lost productivity among parents/caregivers, estimated to cost more than $1 billion.

Pearls And Alerts

Asthma Module Authors

The authors listed above are responsible for the overall Asthma Module. Authors contributing to individual pages in the module are listed on those pages.

Page Bibliography

Akinbami L.
The state of childhood asthma, United States, 1980-2005.
Adv Data. 2006;(381):1-24. PubMed abstract

Lenney W.
The burden of pediatric asthma.
Pediatr Pulmonol Suppl. 1997;15:13-16. PubMed abstract

Mielck A, Reitmeir P, Wjst M.
Severity of childhood asthma by socioeconomic status.
Int J Epidemiol. 1996;25(2):388-93. PubMed abstract / Full Text

National Asthma Education and Prevention Program Expert Panel.
Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma - Summary Report 2007.
National Institutes of Health: National Heart, Lung, and Blood Institute; (2007) http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Accessed on 3/31/08.

Utah Department of Health.
Asthma in Utah - Burden Report 2007.
Utah Department of Health. 2007. / http://www.health.utah.gov/asthma/pdf_files/Data/Burden_%20Report.pdf