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At-risk children with asthma (ARC): a systematic review

Audrey Buelo, Susannah McLean, Steven Julious, et al.
Thorax Epub ahead of print: 01 June 2018.
doi: 10.1136/thoraxjnl-2017-210939

According to the 2014 National Review of Asthma Deaths, 25,000 children are admitted annually with an asthma attack, affecting quality of life for those affected.

Many factors are linked with an increased risk of attack, but their relative contribution to increased risk is not clear. This systematic review aimed to identify factors associated with the risk of attack in children aged 5–12 years with asthma, and to weight their importance and the strength of the underpinning evidence to inform risk stratification.

Following Cochrane methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), the authors considered 68 papers from 16,109 records. Children with a history of previous attacks and persistent asthma symptoms were at greatly increased risk, particularly if they had poor access to care. Those with a sub-optimal drug regimen, combined atopic/allergic disease, an African-American ethnicity, with vitamin D deficiency and affected by poverty were at moderately increased risk. Younger age, being overweight, exposure to environmental tobacco smoke and low parental education were associated with slightly increased risk. No increased risk was associated with gender, urban residence and Hispanic ethnicity.

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