Estimating the prevalence of chronic conditions in children who die in England, Scotland and Wales: a data linkage cohort study
Estimating the prevalence of chronic conditions in children who die in England, Scotland and Wales: a data linkage cohort study
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DOI：
10.1136/bmjopen-2014-005331
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Gilbert, Ruth
中科院分区：
文献类型：
--
作者：
Hardelid, Pia;Dattani, Nirupa;Gilbert, Ruth
目的：估计死于慢性病的儿童比例，并检查涉及慢性病的儿童死亡的时间趋势。设计：使用关联的死亡证明和出院记录进行基于人群的回顾性死亡队列研究。地点：英格兰、苏格兰和威尔士。参与者：2001 年至 2010 年间所有 1-18 岁死亡的居民儿童。主要和次要结果指标：主要结果是根据年龄组和慢性病类型，死于慢性病的儿童比例。次要结局是每 10 万名儿童中涉及慢性病的死亡率随时间的变化趋势，以及死于慢性病的儿童比例的趋势。 结果：根据死亡证明信息，23 438 名儿童中有 65.4%（95% CI 64.8%，66.0%）死于慢性病。如果还包括死亡前 1 年的医院记录，这一比例将增加至 70.7%（95% CI 70.1% 至 71.3%），并且在 15 岁以下儿童中最高（74.8-79.9%，取决于年龄组）。使用死亡证明中的数据只会导致对除癌症/血液病之外的所有类型的慢性病的确定不足。神经/感觉疾病最为常见（占 38.5%）。自2001年以来，死于慢性病的儿童比例有所下降，而受慢性病影响的死亡比例保持稳定。结论：大多数死亡儿童患有慢性病。神经/感觉疾病最为普遍。死亡证明和出院数据之间的联系避免了死亡证明上对非癌症疾病的一些记录不足，并提供了一种低成本、基于人群的方法来监测死亡儿童的慢性疾病。
Objectives: To estimate the proportion of children who die with chronic conditions and examine time trends in childhood deaths involving chronic conditions.Design: Retrospective population-based death cohort study using linked death certificates and hospital discharge records.Setting: England, Scotland and Wales.Participants: All resident children who died aged 1-18 years between 2001 and 2010.Primary and secondary outcome measures: The primary outcome was the proportion of children who died with chronic conditions according to age group and type of chronic condition. The secondary outcome was trends over time in mortality rates involving chronic conditions per 100 000 children and trends in the proportion of children who died with chronic conditions.Results: 65.4% of 23 438 children (95% CI 64.8%, 66.0%) died with chronic conditions, using information from death certificates. This increased to 70.7% (95% CI 70.1% to 71.3%) if hospital records up to 1 year before death were also included and was highest (74.8-79.9% depending on age group) among children aged less than 15 years. Using data from death certificates only led to underascertainment of all types of chronic conditions apart from cancer/blood conditions. Neurological/sensory conditions were most common (present in 38.5%). The rate of children dying with a chronic condition has declined since 2001, whereas the proportion of deaths affected by chronic conditions remained stable.Conclusions: The majority of children who died had a chronic condition. Neurological/sensory conditions were the most prevalent. Linkage between death certificate and hospital discharge data avoids some of the underrecording of non-cancer conditions on death certificates, and provides a low-cost, population-based method for monitoring chronic conditions in children who die.