668 Younger Children are More Reliable in Estimating the Severity of Asthma Attack Comparing to Parents and Older Children

Background and Aims Many studies emphasize that child’s perception of asthma symptoms is not reliable. We assessed correlation between objective and subjective asthma attack estimation and analyzed factors that affect objectivity. Methods Independently from parents, 33 children ages 5–18 years estimated asthma attack severity from 0–10 by visual analog scale score (VASS) - subjective estimation. Objective estimation for each child was done in two ways: comparing absolute values of lung function parameters (LFP) with Zapletal’s norms (ZN): LFP%ZN by Jeager Flowscreen spirometer, and with individual best values during optimal disease control, individual norms (IN): LFP%IN. We analyzed the correlation between subjective and objective estimations. Results VASS of children and parents were not in mutual correlation. VASS of children and parents were not in correlation with spirometric estimation (LFP%ZN). In younger children, correlation becomes statistically significant if we use IN instead of ZN (LFP%IN): r= –0.45, p=0.049 (FEV1); r= –0.52, p=0.020 (MEF50); r= –0.6, p=0.005 (MEF25). VASS of their parents were not in correlation with LFP%IN. In 15 of 20 cases, IN of younger children were higher than ZN, thus more valid. On the contrary, IN of older children were mainly below ZN (in 10 of 13), thus less reliable for estimation. In this group there was no correlation regardless of applied norm and whether the estimation was done by child or a parent. Conclusions Children ages 5–10 years are more reliable in estimating the severity of asthma attack than older children and their parents who are adapted to lower child’s possibilities.