Past history:
(1) sudden severe exacerbations of asthma
(2) intubation because of asthma
(3) admission to the intensive care unit because of asthma
(4) >= 3 emergency room visits for asthma in the past year
(5) >= 2 hospitalizations for asthma in the past year
(6) emergency room visit or hospitalization for asthma within the past month
Concurrent diseases:
(1) serious psychiatric disease or psychosocial problems
(2) significant comorbid disease (cardiovascular disease, COPD, etc.)
(3) illicit drug abuse
Therapeutic factors:
(1) use of > 2 canisters of inhaled short-acting beta-2-agonist per month
(2) current use of systemic corticosteroids
(3) recent withdrawal from systemic corticosteroids
Other factors:
(1) difficulty in perceiving airflow obstruction or its severity
(2) sensitivity to Alternaria
(3) low socioeconomic status with urban residence
