{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:35:16Z","timestamp":1778870116975,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Awareness of factors associated with life\u2010threatening asthma attacks and asthma mortality is essential for risk prediction in asthma care. There is limited evidence to inform risk factors in children and young people (CYP). The aim of this systematic review is to synthesize existing data to report risk factors for life\u2010threatening asthma attacks and asthma deaths in CYP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review followed PRISMA\u2010reporting\u2010guidelines and was registered on PROSPERO (CRD42023494203). We included observational studies of CYP aged 0\u221218 years with asthma, published in English, from 2000 to the present, exploring variables influencing asthma mortality and life\u2010threatening attacks (defined as intensive care [ICU] admissions). CINAHL, MEDLINE, Central Cochrane Library, and Scopus databases were searched. Reference lists of eligible studies were screened. The MEDLINE search strategy was adapted across the databases. Results were synthesized narratively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six studies met our inclusion criteria (five retrospective cohort, one case\u2010control study). All were conducted in high\u2010income countries. In descending order of strength of association, factors found to be associated with ICU admissions were: high salbutamol use, previous hospitalization, low socioeconomic status, allergies, Black ethnicity, prescription of asthma medications, history of pneumonia, rural location, adolescence, paternal asthma, and co\u2010existing comorbidity.<\/jats:p>\n                    <jats:p>For the outcome of mortality, one study reported a sevenfold risk of asthma death in children of Black ethnicity compared with White.<\/jats:p>\n                    <jats:p>The included studies had low quality of evidence by the GRADE assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The small number and high heterogeneity between available studies, identifies a need for robust epidemiological studies and better risk prediction for near\u2010fatal and fatal attacks in CYP\u2010asthma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71255","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T11:33:39Z","timestamp":1755603219000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk Factors for Life\u2010Threatening Asthma Attacks and Asthma\u2010Related Mortality in Children\u2014A Systematic Review"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3757-2606","authenticated-orcid":false,"given":"Aleksandra","family":"Gawlik\u2010Lipinski","sequence":"first","affiliation":[{"name":"University of Leicester Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Hassen","sequence":"additional","affiliation":[{"name":"University of Leicester Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manisha","family":"Ramphul","sequence":"additional","affiliation":[{"name":"University of Leicester Leicester UK"},{"name":"University Hospitals of Leicester NHS Trust Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erol A.","family":"Gaillard","sequence":"additional","affiliation":[{"name":"University of Leicester Leicester UK"},{"name":"University Hospitals of Leicester NHS Trust Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenni K.","family":"Quint","sequence":"additional","affiliation":[{"name":"Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare L.","family":"Gillies","sequence":"additional","affiliation":[{"name":"University of Leicester Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Lo","sequence":"additional","affiliation":[{"name":"University of Leicester Leicester UK"},{"name":"University Hospitals of Leicester NHS Trust Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"\u201cBTS\/SIGN British Guideline on the Management of Asthma \u201d BTS\/SIGN (2019) https:\/\/www.brit-thoracic.org.uk\/quality-improvement\/guidelines\/asthma."},{"key":"e_1_2_10_3_1","unstructured":"\u201cGlobal Strategy for Asthma Management and Prevention GINA (2024) https:\/\/ginasthma.org\/wp-content\/uploads\/2024\/05\/GINA-2024-Strategy-Report-24_05_22_WMS.pdf."},{"key":"e_1_2_10_4_1","unstructured":"\u201cAsthma: Key Facts \u201d World Health Organization (2024)."},{"key":"e_1_2_10_5_1","unstructured":"\u201cAsthma Statistics \u201d BLF (2023) https:\/\/statistics.blf.org.uk\/asthma."},{"key":"e_1_2_10_6_1","unstructured":"\u201cAsthma: Diagnosis Monitoring and Chronic Asthma Management. Joint Guidelines \u201d BTS\/NICE\/SIGN (2024) https:\/\/www.nice.org.uk\/guidance\/NG245."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2017-210939"},{"key":"e_1_2_10_8_1","unstructured":"\u201cThe Global Asthma Report 2022 \u201d GAN (2022)."},{"key":"e_1_2_10_9_1","unstructured":"\u201cWhy Asthma Still Kills: The National Review of Asthma Deaths (NRAD) Confidential Enquiry Report \u201d Royal College of Physicians 2014."},{"key":"e_1_2_10_10_1","unstructured":"\u201cAsthma Facts and Figures \u201d America AaAFo (2024) https:\/\/aafa.org\/asthma\/asthma-facts\/."},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","unstructured":"R.Shah \u201cInternational Comparisons of Health and Wellbeing in Adolescence and Early Adulthood. 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