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Past asthma exacerbation in children predicting future exacerbation: a systematic review
Acute exacerbations are common in children and potentially preventable. Currently, a past exacerbation is the best predictor of a future exacerbation. We undertook a systematic review of the literature describing the relationship between past and future exacerbations. Our analysis considered whether...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9661269/ https://www.ncbi.nlm.nih.gov/pubmed/36382233 http://dx.doi.org/10.1183/23120541.00174-2022 |
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author | Lowden, Rachel Turner, Steve |
author_facet | Lowden, Rachel Turner, Steve |
author_sort | Lowden, Rachel |
collection | PubMed |
description | Acute exacerbations are common in children and potentially preventable. Currently, a past exacerbation is the best predictor of a future exacerbation. We undertook a systematic review of the literature describing the relationship between past and future exacerbations. Our analysis considered whether the odds ratios for one exacerbation to predict a recurrence were different across different categories of exacerbation. Four databases were searched systematically (MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health and PsycInfo). Exacerbations were categorised by severity as: presentation to emergency department (ED); hospital admission; paediatric intensive care unit (PICU) admission; and “unspecified severity” (i.e. no distinction between severity categories was made). Meta-analysis was performed for studies where sufficient data were provided for inclusion. There were 26 eligible articles from 9185 identified. There was significant heterogeneity in duration of follow-up, healthcare system and exacerbation definition between studies. For the unspecified severity definition, the odds ratio for an exacerbation after a previous exacerbation was 9.87 (95% CI 5.02–19.39; six studies, 162 583 individuals). PICU admission was also associated with increased risk of future admission (OR 5.87, 95% CI 2.96–11.64; two studies, 730 individuals). Meta-analysis was not possible for ED visits or hospitalisation. The median odds ratio (range) for past ED visit predicting future ED visit was 6.27 (3.3–8.26) and for past hospitalisation predicting future hospitalisation was 3.37 (1.89–5.36). The odds for a second asthma exacerbation do not necessarily increase with increasing severity of an initial exacerbation. |
format | Online Article Text |
id | pubmed-9661269 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-96612692022-11-14 Past asthma exacerbation in children predicting future exacerbation: a systematic review Lowden, Rachel Turner, Steve ERJ Open Res Original Research Articles Acute exacerbations are common in children and potentially preventable. Currently, a past exacerbation is the best predictor of a future exacerbation. We undertook a systematic review of the literature describing the relationship between past and future exacerbations. Our analysis considered whether the odds ratios for one exacerbation to predict a recurrence were different across different categories of exacerbation. Four databases were searched systematically (MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health and PsycInfo). Exacerbations were categorised by severity as: presentation to emergency department (ED); hospital admission; paediatric intensive care unit (PICU) admission; and “unspecified severity” (i.e. no distinction between severity categories was made). Meta-analysis was performed for studies where sufficient data were provided for inclusion. There were 26 eligible articles from 9185 identified. There was significant heterogeneity in duration of follow-up, healthcare system and exacerbation definition between studies. For the unspecified severity definition, the odds ratio for an exacerbation after a previous exacerbation was 9.87 (95% CI 5.02–19.39; six studies, 162 583 individuals). PICU admission was also associated with increased risk of future admission (OR 5.87, 95% CI 2.96–11.64; two studies, 730 individuals). Meta-analysis was not possible for ED visits or hospitalisation. The median odds ratio (range) for past ED visit predicting future ED visit was 6.27 (3.3–8.26) and for past hospitalisation predicting future hospitalisation was 3.37 (1.89–5.36). The odds for a second asthma exacerbation do not necessarily increase with increasing severity of an initial exacerbation. European Respiratory Society 2022-11-14 /pmc/articles/PMC9661269/ /pubmed/36382233 http://dx.doi.org/10.1183/23120541.00174-2022 Text en Copyright ©The authors 2022 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Original Research Articles Lowden, Rachel Turner, Steve Past asthma exacerbation in children predicting future exacerbation: a systematic review |
title | Past asthma exacerbation in children predicting future exacerbation: a systematic review |
title_full | Past asthma exacerbation in children predicting future exacerbation: a systematic review |
title_fullStr | Past asthma exacerbation in children predicting future exacerbation: a systematic review |
title_full_unstemmed | Past asthma exacerbation in children predicting future exacerbation: a systematic review |
title_short | Past asthma exacerbation in children predicting future exacerbation: a systematic review |
title_sort | past asthma exacerbation in children predicting future exacerbation: a systematic review |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9661269/ https://www.ncbi.nlm.nih.gov/pubmed/36382233 http://dx.doi.org/10.1183/23120541.00174-2022 |
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