The influence of disparities on intensive care outcomes in children with
respiratory diseases: a systematic review
Abstract
Context – The negative effects of socioeconomic, environmental and
ethnic inequalities on childhood respiratory diseases are known in the
development of persistent asthma and can result in adverse outcomes.
However, little is known about the effects of these disparities on
pediatric intensive care unit (PICU) outcomes in respiratory diseases.
Objective – The purpose of this systematic review is to evaluate the
literature on disparities in socioeconomic, environmental and ethnic
determinants on PICU outcomes. We hypothesize that these disparities
negatively influence the outcomes of children’s respiratory diseases at
the PICU. Methods – A literature search (in PubMed, Embase.com and Web
of Science Core Collection) was performed up to September 30, 2022. Two
authors extracted the data and independently evaluated the risk of bias
with appropriate assessment methods. Articles were included if the
patients were below 18 years of age (excluding neonatal intensive care
unit admissions), they concerned respiratory diseases and incorporated
socioeconomic, ethnic or environmental disparities. Results – Of 8746
references reviewed, 15 articles were included; seven articles on the
effect of socioeconomic status, five articles on ethnicity, one on the
effect of sex and lastly two on environmental factors. All articles but
one showed an unfavorable outcome at the PICU. Conclusion – Disparities
in socioeconomic (such as a low-income household, public health
insurance), ethnic and environmental factors (such as exposure to
tobacco smoke and diet) have been assessed as risk factors for the
severity of children’s respiratory diseases and can negatively influence
the outcomes of these children at the PICU.