Mortality and morbidity in children with asthma: A nationwide study in Korea

Objective: Childhood mortality due to asthma remains problematic; however, asthma-related mortality in Korean children has not been previously described. This study aimed to estimate asthma mortality and morbidity and determine to what extent asthma contributes to childhood mortality in Korea. Methods: Data from 9 to 12 million children (aged < 18 years) per year recorded for each year between 2002 and 2015 were retrieved from the Korea National Health Insurance claims database. Patients with asthma during the year preceding death were investigated. Causes of death were analysed using data obtained from the Korean Statistical Information Service database. Cause-specific mortality was examined, and the mortality rate of children with asthma was compared to that of the general paediatric population with respect to the cause of death and age. Hospital use by patients with asthma, including intensive care unit admission and hospitalisation, was analysed. Results: Asthma mortality decreased from 0.09 per 100,000 children in 2003 to 0.02 per 100,000 children in 2014, with an average mortality of 0.06 per 100,000 children. Mortality due to respiratory diseases was four times more common in patients with asthma than in the general population of children aged >5 years, despite decreases in asthma-related mortality. Asthma-related hospitalisations and intensive care interventions tended to decrease throughout the study period. Conclusions: Asthma mortality declined in children between 2003 and 2015 in Korea. Children with asthma are at a higher risk of death from respiratory diseases than the general population.