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Risk factors for childhood asthma deaths from the UK Eastern Region Confidential Enquiry 2001-2006.
MedLine Citation:
PMID:  22218820     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Confidential enquiries into asthma deaths can identify inadequacies in medical management and factors which contribute to patients' death. AIMS: To identify risk factors for paediatric asthma deaths over a 6-year period. METHODS: Observational case-series study of paediatric asthma deaths between 2001-2006 in the UK Eastern Region. Hospital, primary care and post-mortem data were obtained for every child (≤17 yrs) with asthma recorded on the death certificate, and a detailed questionnaire was completed. Information was obtained on asthma severity, medications, hospital admissions, GP and hospital follow-up, adherence, psychosocial / behavioural factors, allergies, details of the terminal attack and precipitating factors. RESULTS: 20 children (10 male; 8-17yrs; median: 11.5yrs) died of asthma between 2001-2006. 9/20 had mild to moderate asthma (BTS/ SIGN criteria), 10/20 had severe asthma and 1 child was not known to have asthma. 13/20 were clinically atopic. Only 3 had undergone allergy assessment. 10/20 died between June and August. 12/20 children had adverse psychosocial and behavioural factors. 7/20 children were on non-combination long-acting β2-agonist (LABA) treatment without inhaled corticosteroids (ICS). CONCLUSIONS: Almost half the deaths occurred in children with mild/moderate asthma. We recommend that allergic factors and seasonal allergy should be identified early, non-combination LABAs avoided, and speculate that overuse of short-acting β2-agonists (SABAs) may indicate non-adherence with ICS. Asthma deaths in children can be avoided if risk factors are identified early.
Authors:
Katherine Anagnostou; Brian Harrison; Richard Iles; Shuaib Nasser
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-4
Journal Detail:
Title:  Primary care respiratory journal : journal of the General Practice Airways Group     Volume:  -     ISSN:  1475-1534     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101121543     Medline TA:  Prim Care Respir J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Allergy, Cambridge University Hospitals NHS Trust, Cambridge, UK.
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