Trends in Pediatric Sickle Cell Disease-Related Mortality in the United States, 1983-2002
Trends in Pediatric Sickle Cell Disease-Related Mortality in the United States, 1983-2002
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DOI：
10.1016/j.jpeds.2008.09.052
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发表时间：
2009-04-01
影响因子：
5.1
通讯作者：
Olney, Richard S.
中科院分区：
文献类型：
--
作者：
Yanni, Emad;Grosse, Scott D.;Olney, Richard S.
目的分析1983-2002年黑人儿童镰状细胞病（SCD）相关死亡率的变化趋势。研究设计使用疾病控制和预防中心的国家卫生统计中心汇编的多原因死亡率文件，我们分析了14岁及以下的黑人儿童的死亡情况，这些儿童在死亡证明上被确定为SCD。结果与1983-1986年相比，1999-2002年SCD死亡率在0 - 3岁下降68%(95%可信区间[CI] = 58% - 75%)，在4 -9岁下降39% (95% CI = 16% - 56%)，在10 - 14岁下降24% （95% CI = -9% - 47%）。在最近的研究期间，1995-1998年和1999-2002年期间，0至3岁儿童死亡率显著下降（42%），而老年儿童SCD死亡率基本没有下降。结论：最近4岁以下黑人儿童SCD死亡率的下降与2000年7价肺炎球菌结合疫苗的引入一致，尽管时间相关性并不能证明因果关系。近期大龄儿童SCD死亡率缺乏显著降低表明需要新的治疗方法。[J]儿科杂志2009；154:541-5。
Objective To analyze trends in sickle cell disease (SCD)-related mortality among black children during 1983-2002.Study design Using the multiple-cause mortality files compiled by the Centers for Disease Control and Prevention's National Center for Health Statistics, we analyzed deaths among children classified as black who were age 14 years and younger and had SCD identified on their death certificates.Results Relative to the rate for 1983-1986, the SCD mortality rate for 1999-2002 decreased by 68% (95% confidence interval [CI] = 58% to 75%) at age 0 to 3 years, by 39% (95% CI = 16% to 56%) at age 4 to 9 years, and by 24% (95% CI = -9% to 47%) at age 10 to 14 years. For the most recent period studied, a significant (42%) reduction in mortality at age 0 to 3 years was seen between 1995-1998 and 1999-2002, with essentially no reduction in SCD mortality at older ages.Conclusions Recent decreases in SCD mortality in black children under age 4 years coincided with the introduction of the 7-valent pneumococcal conjugate vaccine in 2000, although temporal association is not evidence of causation. The lack of significant recent reduction in SCD mortality in older children indicates the need for new treatment approaches. (J Pediatr 2009;154:541-5)