Risk factors for childhood asthma deaths from the UK Eastern Region Confidential Enquiry 2001-2006

Prim Care Respir J. 2012 Mar;21(1):71-7. doi: 10.4104/pcrj.2011.00097.


Background: Confidential enquiries into asthma deaths can identify inadequacies in medical management and factors which contribute to patients' death.

Aims: To identify risk factors for paediatric asthma deaths over a 6-year period.

Methods: Observational case-series study of paediatric asthma deaths between 2001-2006 in the UK Eastern Region. Hospital, primary care and post-mortem data were obtained for every child (≤17 yrs) with asthma recorded on the death certificate, and a detailed questionnaire was completed. Information was obtained on asthma severity, medications, hospital admissions, GP and hospital follow-up, adherence, psychosocial / behavioural factors, allergies, details of the terminal attack and precipitating factors.

Results: 20 children (10 male; 8-17 yrs; median: 11.5 yrs) died of asthma between 2001-2006. 9/20 had mild to moderate asthma (BTS/ SIGN criteria), 10/20 had severe asthma and 1 child was not known to have asthma. 13/20 were clinically atopic. Only 3 had undergone allergy assessment. 10/20 died between June and August. 12/20 children had adverse psychosocial and behavioural factors. 7/20 children were on non-combination long-acting β2-agonist (LABA) treatment without inhaled corticosteroids (ICS).

Conclusions: Almost half the deaths occurred in children with mild/moderate asthma. We recommend that allergic factors and seasonal allergy should be identified early, non-combination LABAs avoided, and speculate that overuse of short-acting β2-agonists (SABAs) may indicate non-adherence with ICS. Asthma deaths in children can be avoided if risk factors are identified early.

MeSH terms

  • Adolescent
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / classification
  • Asthma / complications
  • Asthma / drug therapy
  • Asthma / mortality*
  • Child
  • Drug Therapy, Combination
  • Female
  • Guideline Adherence
  • Humans
  • Hypersensitivity / complications*
  • Male
  • Medication Adherence*
  • Primary Health Care
  • Pulmonary Medicine
  • Risk Factors
  • Severity of Illness Index
  • United Kingdom / epidemiology


  • Anti-Asthmatic Agents