Abstract

Aim:
To review existing evidence to identify risk factors for life-threatening asthma attacks and asthma deaths in children and young people (CYP)

Method:
The Systematic review followed PRISMA reporting guidelines and was registered on PROSPERO (CRD42023494203). The review included observational studies published in English, using data collected from 2000 onwards, concerning patients aged 0-18 with diagnosis of asthma, and exploring variables influencing asthma mortality and life-threatening asthma attacks in children. The latter were defined as Intensive Care Unit (ICU) admissions.
The search was conducted across the electronic databases CINAHL, MEDLINE, Central Cochrane Library, and Scopus. Reference lists of eligible studies were screened.
MEDLINE search strategy was adapted in the database search, with Medical Subject Headings terms and free text terms corresponding to the population: “asthma* and “child*”, exposure of “risk*”, and outcomes of “mortality” and “life-threatening”.

Results (preliminary):
The database search identified a total of 10072 studies. After the duplicates removal 5874 titles and abstracts were screened for eligibility. 186 studies were sought for full-text retrieval, of which 1 article was unavailable. 6 studies met the inclusion criteria.
2 of the included studies were conducted in the USA, and the remaining 5 respectively in Canada, the UK, Korea, and the Netherlands. 5 studies are retrospective cohort studies, and 1 is a retrospective case-control study. Further analysis and synthesis of the data is currently being conducted.

Conclusion:
The initial overview of the included studies revealed that the risk factors for asthma mortality and ICU admission were only explored in high-income countries (USA, Canada, Korea, UK, Netherlands). The small number of studies indicates that there is a lack of research concerning risk factors for ICU admission and asthma mortality in CYP. Further research in the form of epidemiological studies is recommended to address the gap in evidence.