{
  "abstract": "Introduction Despite available treatments, there remains an unacceptably high number of asthma deaths in children and young people(CYP) in the UK, many of which are preventable (NRAD 2014). A 2024 report from the National Child Mortality Database reported 54 asthma deaths between 2019–2023. Temporal trends in fatal and near-fatal asthma, and how these differ between different ethno-socioeconomic groups, are unknown.Aim To describe longitudinal trends in fatal and life-threatening asthma (defined as an ICU-admission) over the past 20 years in CYP in England, stratified by socioeconomic and ethnic groups.Methods We conducted a retrospective cohort study using routinely collected linked primary and secondary care, and administrative data from the Clinical Practice Research Datalink (CPRD), Hospital Episode Statistics (HES), Office for National Statistics (ONS) mortality data, and the Index of Multiple Deprivation (IMD). We included CYP aged 5–21 in any year since 2002, with an asthma ICD-10 code as the primary reason for an ICU-admission, or as the underlying cause of death. We estimated the incidence rate of asthma deaths and life-threatening attacks for each year, followed by a meta-regression to explore temporal trends, using aggregated annual incidence and year as a covariate.Results Cohort characteristics were stratified by sex, ethnicity, region, and IMD ( table 1). Approximately 12% of the cohort were non-white, and 24% from the most-deprived areas.Between 2002–2022, there were 113 CYP asthma deaths; among them, 21% were non-white, and 39% were from the most-deprived areas. Mean incidence was 0.20 deaths per 100,000 per year. There was no significant change in annual asthma mortality rate in CYP over the past 20 years(Coefficient 0(SE=0.003,95%CI-0.006- 0.00,p=1.0).A total of 1,955 CYP were admitted to ICU with life-threatening asthma between 2008–2022; 33% were non-white, and 34% were from the most-deprived areas. The mean ICU admission incidence rate was 4.3 per 100,000 per year. There was no significant change in life-threatening asthma ICU admission trends over time(Coefficient-1.16x10− 1 6 (SE=0.025, 95%CI -0.05–0.05, p=1.00).Abstract S43 Table 1 Asthma mortality Asthma ICU admission Asthma population total Characteristic Total n=113 Total n= 1955 Total n= 1 363 839 Age at event (years), mean (SD) 13.93 (4.33) 14.06 (5.14) Not applicable Age categories at event (years), n (%) 5- 11 43 (38%) 756 (38.7%) 12- 18 50 (44.3%) 744 (38%) 19- 21 20 (17.7%) 455 (23.3%) Sex, n (%) Male 57 (50.4%) 924 (47.3%) 689 410 (50.6%) Female 56 (49.6%) 1031 (52.7%) 674 341 (49.4%) Ethnicity, n (%) White 77 (68.1%) 1215 (62.1%) 907 937 (66.6%) Black 14 (12.4%) 276 (14.1%) 52 898 (3.9%) South Asian 9 (8%) 222 (11.4%) 79 271 (5.8%) Mixed ≤5 (≤1.0%)* 139 (7.1%) 36 157 (2.6%) Missing or unknown 12 (10.6%) 35 (1.8%) 257 753 (18.9%) Other ≤5 (≤1.0%)* 68 (3.5%) 29 823 (2.2%) IMD quintile, n (%) 112 (data for one child missing) 1947 (missing data for 8 CYP) Total for IMD 1 360 792 (missing data for 3 047) 1 Least deprived 13 (11.6%) 207 (10.6%) 232 532 (17.1%) 2 14 (12.5%) 243 (12.5%) 248 551 (18.3%) 3 15 (13.4%) 336 (17.3%) 255 033 (18.7%) 4 26 (23.2%) 493 (25.3%) 297 060 (21.8%) 5 Most deprived 44 (39.3%) 668 (34.3%) 327 616 (24.1%) Region, n (%) North East 7 (6.2%) 30 (1.5%) 42 143 (3.1%) North West 23 (20.3%) 222 (11.4%) 255 948 (18.8%) Yorkshire ≤5(≤5%)* 65 (3.3%) 57 455 (4.2%) East Midlands ≤5 (≤5%)* 31 (1.6%) 47 975 (3.5%) West Midlands 19 (16.8%) 414 (21.2%) 212 776 (15.6%) East of England ≤5 (≤5%)* 54 (2.8%) 51 440 (3.8%) London 28 (24.8%) 552 (28.2%) 244 759 (18%) South East 16 (14.2%) 300 (15.3%) 273 780 (20%) South West 12 (10.6%) 287 (14.7%) 177 563 (13%) * Exact data in cells with counts ≤5 have been suppressed for confidentiality reasonsConclusions Our data show that trends in asthma mortality and ICU admissions have not improved over time. Moreover, children from non-white ethnicity, and the most-deprived areas appear to be disproportionately affected.",
  "authors": [
    {
      "affiliations": [
        "University of Leicester, Leicester, UK"
      ],
      "name": "A Gawlik-Lipinski"
    },
    {
      "affiliations": [
        "University of Leicester, Leicester, UK"
      ],
      "name": "S Shabnam"
    },
    {
      "affiliations": [
        "Imperial College London, London, UK"
      ],
      "name": "JK Quint"
    },
    {
      "affiliations": [
        "University of Leicester, Leicester, UK"
      ],
      "name": "CL Gillies"
    },
    {
      "affiliations": [
        "University of Leicester, Leicester, UK"
      ],
      "name": "DKH Lo"
    }
  ],
  "title": "S43 Longitudinal trends in asthma mortality and life-threatening asthma in children in England",
  "uid": "2fe86391-a825-5fae-821d-e15a3387c0c1"
}