Timing and causes of death to 1 year among children presenting to emergency departments.
Timing and causes of death to 1 year among children presenting to emergency departments.
复制标题
到急诊室就诊的儿童至 1 岁的死亡时间和原因。
DOI：
10.1111/acem.14875
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
PediatricReadinessStudyGroup
中科院分区：
文献类型：
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作者：
Ames,StefanieG;Salvi,Apoorva;Lin,Amber;Malveau,Susan;Mann,NClay;Jenkins,PeterC;Hansen,Matthew;Papa,Linda;Schmitz,Sabrina;Sabogal,Cesar;Newgard,CraigD;PediatricReadinessStudyGroup
背景和目的：需要更好地描述急诊后儿童死亡的特征，以便及时采取干预措施。本研究旨在描述受伤和内科疾病儿童队列中1年内死亡的时间、地点和原因。MethodsWe对2012年1月1日至2017年12月31日期间六个州需要急诊护理的<18岁儿童进行了回顾性队列研究，随访至2018年12月31日，对于未从急诊科（艾德）出院的患者。在这个队列中，从艾德、住院患者和生命状态记录中评估了1年死亡率、1年内死亡时间和死亡原因。受伤儿童的1年死亡率为2.2%（n= 1356），内科疾病儿童的1年死亡率为1.4%（n= 6687）。受伤队列中1356例死亡中有861例（63.5%）和医疗队列中6687例死亡中有4712例（70.5%）获得了匹配的死亡证明。在损伤队列的死亡中，1274例（94.0%）发生在艾德或医院。最常见的死亡原因是机动车碰撞、火器伤害和行人受伤。在医疗队列的6687例死亡中，5081例（76.0%）儿童在艾德或医院（主要在艾德）死亡，1606例（24.0%）发生在出院后。最常见的死亡原因是婴儿猝死综合征，窒息和溺水，和先天性conditions.ConclusionsThe 1年死亡率的儿童提出了一个艾德是2.2%的受伤儿童和1.4%的医学疾病的儿童与大多数死亡发生在ED。未来的干预试验，质量改进的努力，和卫生政策集中在艾德可能有潜力改善儿童患者的结果。
Background and objectivesA better characterization of deaths in children following emergency care is needed to inform timely interventions. This study aimed to describe the timing, location, and causes of death to 1 year among a cohort of injured and medically ill children.MethodsWe conducted a retrospective cohort study of children <18 years requiring emergency care in six states from January 1, 2012, through December 31, 2017, with follow‐up through December 31, 2018, for patients who were not discharged from the emergency department (ED). In this cohort, 1‐year mortality, time to death within 1 year, and causes of death were assessed from ED, inpatient, and vital status records.ResultsThere were 546,044 children during the 6‐year period. The 1‐year mortality rate was 2.2% (n= 1356) for injured children and 1.4% (n= 6687) for medically ill children. Matched death certificates were available for 861 (63.5%) of 1356 deaths in the injury cohort and for 4712 (70.5%) of 6687 deaths in the medical cohort. Among deaths in the injury cohort, 1274 (94.0%) occurred in the ED or hospital. The most common causes of death were motor vehicle collisions, firearm injuries, and pedestrian injuries. Among the 6687 deaths in the medical cohort, 5081 (76.0%) children died in the ED or hospital (primarily in the ED) and 1606 (24.0%) occurred after hospital discharge. The most common causes of death were sudden infant death syndrome, suffocation and drowning, and congenital conditions.ConclusionsThe 1‐year mortality of children presenting to an ED is 2.2% for injured children and 1.4% for medically ill children with most deaths occurring in the ED. Future interventional trials, quality improvement efforts, and health policy focused in the ED could have the potential to improve outcomes of pediatric patients.