Wildfire et al reported the Composite Asthma Severity Index (CASI) to evaluate asthma in pediatric patients. It measures the multidimensional nature of asthma. The authors are from multiple institutions in the United States.
Patient selection: child or adolescent with asthma
Parameters:
(1) number of days with symptoms and albuterol during the last 2 weeks
(2) number of nights with symptoms and albuteral during the last 2 weeks
(3) FEV1 as percent of predicted
(4) controller treatment
(5) exacerbations in the last 2 months
Parameter
Finding
Points
number of days with symptoms
0-3
0
4-9
1
10-13
2
14
3
number of nights with symptoms
0-1
0
2
1
3-4
2
5-14
3
FEV1
> 85% of predicted
0
80-84%
1
70-79%
2
< 70% of predicted
3
controller treatment
none
0
albuterol
1
singulair
2
low dose inhaled steroids
2
low dose inhaled steroids plus LABA
3
medium dose inhaled steroids
3
medium dose inhaled steroids plus LABA
4
high dose inhaled steroids
5
points for exacerbation =
= MIN(6,(((number of hospitalizations)*2)+((number of episodes requiring prednisone bursts)*2)))
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the index the greater the asthma severity.
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