{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:54:13Z","timestamp":1772160853658,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T00:00:00Z","timestamp":1584662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["113201006"],"award-info":[{"award-number":["113201006"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","award":["PRJ2284"],"award-info":[{"award-number":["PRJ2284"]}],"id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are sparse real\u2010world data on severe asthma exacerbations (SAE) in children. This multinational cohort study assessed the incidence of and risk factors for SAE and the incidence of asthma\u2010related rehospitalization in children with asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Asthma patients 5\u201017\u00a0years old with \u22651\u00a0year of follow\u2010up were identified in six European electronic databases from the Netherlands, Italy, the UK, Denmark and Spain in 2008\u20102013. Asthma was defined as \u22651 asthma\u2010specific disease code within 3\u00a0months of prescriptions\/dispensing of asthma medication. Severe asthma was defined as high\u2010dosed inhaled corticosteroids plus a second controller. SAE was defined by systemic corticosteroids, emergency department visit and\/or hospitalization all for reason of asthma. Risk factors for SAE were estimated by Poisson regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort consisted of 212\u00a0060 paediatric asthma patients contributing to 678\u00a0625 patient\u2010years (PY). SAE rates ranged between 17 and 198\/1000 PY and were higher in severe asthma and highest in severe asthma patients with a history of exacerbations. Prior SAE (incidence rate ratio 3\u201045) and younger age increased the SAE risk in all countries, whereas obesity, atopy and GERD were a risk factor in some but not all countries. Rehospitalization rates were up to 79% within 1\u00a0year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a real\u2010world setting, SAE rates were highest in children with severe asthma with a history of exacerbations. Many severe asthma patients were rehospitalized within 1\u00a0year. Asthma management focusing on prevention of SAE is important to reduce the burden of asthma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.13237","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T02:48:44Z","timestamp":1583117324000},"page":"496-505","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Incidence, risk factors and re\u2010exacerbation rate of severe asthma exacerbations in a multinational, multidatabase pediatric cohort study"],"prefix":"10.1111","volume":"31","author":[{"given":"Marjolein","family":"Engelkes","sequence":"first","affiliation":[{"name":"Medical Informatics ErasmusMC Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0735-4296","authenticated-orcid":false,"given":"Esme J.","family":"Baan","sequence":"additional","affiliation":[{"name":"Medical Informatics ErasmusMC Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria A. 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