A Survey of Anxiety Sensitivity Index Levels in School-Aged Children With Asthma and a Study of Its Influencing Factors and Predictive Models

Abstract

Background: This study aimed to investigate the current status of anxiety sensitivity index levels in school-aged children with asthma, explore its influencing factors, establish a risk prediction model, and test its predictive effectiveness.

Methods: We retrospectively analysed 400 school-aged children with asthma admitted to Yueqing People’s Hospital between May 2020 and May 2025. The children were randomly divided into a construction group (n = 280) and a validation group (n = 120) at 7:3 ratio. Based on the anxiety sensitivity index levels, the construction group was further divided into a high-anxiety-sensitive group (n = 65) and a low-to-moderate-anxiety-sensitive group (n = 215); the validation group was similarly divided into a high-anxiety-sensitive group (n = 28) and a low-to-moderate-anxiety-sensitive group (n = 92). Clinical data were recorded. A nomogram prediction model was constructed using the R language software package. The model was evaluated using receiver operating characteristic (ROC) curves and calibration curves, and validated using the validation groups samples.

Results: Multivariate analysis of the construction group showed that the main risk factors for high anxiety sensitivity index in school-aged children with asthma were: primary caregiver education level below high school, asthma control status of partial or uncontrolled, primary caregiver monthly income < CNY 4000, incomplete family situation, and Sleep Disorders Scale for Children (SDSC) score ≥39 (p < 0.05). The predictive model constructed from these factors showed good discrimination ability in internal validation, with an area under the curve (AUC) of 0.794 (95% confidence interval [CI]: 0.730–0.858) and a C-index of 0.818 (95% CI: 0.733–0.835). In the validation group, the AUC was 0.799 (95% CI: 0.706–0.892) and a C-index was 0.820 (95% CI: 0.717–0.831), indicating good external predictive power. 

Conclusions: The main risk factors for high anxiety sensitivity index in school-aged children with asthma are: primary caregiver education level below high school, asthma control status of partial or uncontrolled, primary caregiver monthly income < CNY 4000, incomplete family situation, and an SDSC score ≥39. The nomogram model constructed from these factors can effectively predict the risk of high anxiety sensitivity index in school-aged children with asthma.