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Predictors of repeated acute hospital attendance for asthma in children: A systematic review and meta-analysis

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ArduraGarcia, Cristina, Stolbrink, Marie, Zaidi, Seher, Cooper, Philip J. and Blakey, John D. (2018) 'Predictors of repeated acute hospital attendance for asthma in children: A systematic review and meta-analysis'. Pediatric Pulmonology, Vol 53, Issue 9, pp. 1179-1192.

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Abstract

Background
Asthma attacks are common and have significant physical, psychological, and financial consequences. Improving the assessment of a child's risk of subsequent asthma attacks could support front‐line clinicians’ decisions on augmenting chronic treatment or specialist referral. We aimed to identify predictors for emergency department (ED) or hospital readmission for asthma from the published literature.

Methods
We searched MEDLINE, EMBASE, AMED, PsycINFO, and CINAHL with no language, location, or time restrictions. We retrieved observational studies and randomized controlled trials (RCT) assessing factors (personal and family history, and biomarkers) associated with the risk of ED re‐attendance or hospital readmission for acute childhood asthma.

Results
Three RCTs and 33 observational studies were included, 31 from Anglophone countries and none from Asia or Africa. There was an unclear or high risk of bias in 14 of the studies, including 2 of the RCTs. Previous history of emergency or hospital admissions for asthma, younger age, African‐American ethnicity, and low socioeconomic status increased risk of subsequent ED and hospital readmissions for acute asthma. Female sex and concomitant allergic diseases also predicted hospital readmission.

Conclusion
Despite the global importance of this issue, there are relatively few high quality studies or studies from outside North America. Factors other than symptoms are associated with the risk of emergency re‐attendance for acute asthma among children. Further research is required to better quantify the risk of future attacks and to assess the role of commonly used biomarkers.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 320 Child Welfare. Child Health Services.
WF Respiratory System > WF 100 General works
WS Pediatrics > WS 100 General works
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > Well Travelled Clinic (WTC)
Digital Object Identifer (DOI): https://doi.org/10.1002/ppul.24068
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 19 Jun 2018 15:14
Last Modified: 31 Aug 2018 10:10
URI: https://archive.lstmed.ac.uk/id/eprint/8749

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