Abstract
BackgroundIn China, the majority (77%) of urban children die in hospitals. Hospital-based review could provide insight leading to improvements in clinical practice and increase the survival of critically ill children. The aim of the present study is to identify the trends of immediate causes and chronic underlying diseases associated with deaths of children at one of the largest teaching hospitals in China over a period of 10 years (2006–2015).MethodsA retrospective analysis of data of all children aged 1 month to 11 years who died at Xinhua Hospital between 2006 and 2015. Demographic details, main causes of deaths, and chronic underlying diseases were reviewed.ResultsCase fatality rate was 0.55% (510/93,443) and it represented 0.41–0.80% deaths per year. Overall, the most common immediate causes of deaths in hospitalized children were pneumonia (36.7%), sepsis (13.5%), tumour (11.4%), followed by nontraumatic intracranial or gastrointestinal hemorrhage (10.6%) and cardiac shock (9.6%). Over 70% of the deaths in children were complicated with chronic underlying diseases. Congenital abnormality was the most frequent chronic underlying disease observed in infants (60.3%) and tumour was the main chronic underlying disease in toddlers (31.1%) and older children (44%).ConclusionsInfectious diseases, especially pneumonia, were the major immediate causes of deaths, and the mortality in the study population decreased with age. Tumour and other noninfectious disease accounted for more deaths in older children. Chronic underlying diseases were found in most deaths of children.
Highlights
In China, the majority (77%) of urban children die in hospitals
Of all the infectious diseases, pneumonia, sepsis, and CNS infection were the main causes of death throughout childhood
A congenital abnormality was the most frequent chronic underlying disease observed in infants, and this proportion decreased dramatically with age
Summary
Hospital-based review could provide insight leading to improvements in clinical practice and increase the survival of critically ill children. Mortality in children younger than 5 years has dropped from 11.9 million in 1990 to 7.7 million deaths in 2010 [1]. Expecting to achieve the Millennium Development Goal 4, global and local assessments of mortality in newborn and children younger than 5 years are well implemented. These estimations do not provide enough information for the identification of. In China, the majority (77%) of urban children die in hospitals [4].
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