TABLE 4

Definition of asthma exacerbation included in guidelines

Country/organisationFirst author [ref.]Definition of asthma exacerbation
CanadaLougheed [15]NA
Latin America and SpainRodrigo [28]NA
ICON Pediatric AsthmaPapadopoulos [16]An acute or subacute episode of progressive increase in asthma symptoms, associated with airflow obstruction
South AfricaKling [17]Acute asthma is characterised by a progressive increase in shortness of breath, cough, wheeze or tight chest that does not respond to the patient's usual bronchodilator therapy
KoreaKim [18]Asthma exacerbation, or “flare-up”, is defined as acute or subacute worsening of symptoms and lung function compared with the patient's normal status and requires a change in treatment
IndiaAgarwal [15]Asthma exacerbation is characterised by worsening of one or more of the asthma symptoms (cough, wheezing, chest tightness, dyspnoea), leading either to increased need for rescue medications or hospitalisation. It is usually associated with a decline in lung function (PEF or FEV1)
IndiaAgarwal [15]NA
New ZealandAsher [21]NA
New ZealandAsher [21]Asthma exacerbation is defined as acute or subacute worsening of symptoms and lung function compared with the patient's normal status and requires a change in treatment
SpainExecutive Committee GEMA [22]Asthma exacerbation is defined as change of symptoms of the patient requiring a change in treatment
ItalyIndinnimeo [23]NA
SwitzerlandRothe [24]Exacerbations of asthma are episodes of acute or subacute worsening in symptoms and lung function
UKScottish Intercollegiate Guidelines Network, British Thoracic Society [25]NA
GINAGlobal Initiative for Asthma [1]Exacerbations of asthma are episodes of acute or subacute worsening in symptoms and lung function
FranceLe Conte [26]Asthma exacerbation is defined as an imbalance in the asthmatic disorder and is provoked acutely or sub-acutely by an external agent or by poor compliance with treatment
Saudi ArabiaAl-Moamary [27]Acute asthma attack is a challenging clinical scenario that requires a systemic approach to rapidly diagnose the condition, evaluate its severity and initiate therapy

NA: not available; ICON: International Consensus On; GEMA: Guia Espanola para el Manejo del Asma; GINA: Global Initiative for Asthma; PEF: peak expiratory flow; FEV1: forced expiratory volume in 1s.