Objective To analyze the characteristics of mortality cases of hospitalized children in a pediatric hospital in Tianjin from 2009 to2023.
Methods Medical records of hospitalized children in a pediatric hospital in Tianjin from 2009 to 2023 were collected and the gender, age, disease system, and type of death disease from 2009 to 2013, 2014 to 2018, and 2019 to 2023 were analyzed.
Results From 2009 to 2023, there were 678 145 hospitalized children, of whom 876 died, the mortality rate was 0.13%. And the mortality rates for the three time periods were 0.28%, 0.16%, and 0.06%, respectively, showing a decreasing trend (χ2=383.962, P<0.01). The mortality rate of male children (0.12%) was significantly lower than that of female children (0.15%) (χ2=303.785, P<0.01). The highest number of deaths occurred during infancy (263 cases), and the lowest number occurred during adolescence (61 cases). In the changes of the order of death disease system over three periods, circulatory system diseases rose from sixth place to third place; tumors rose from ninth place to sixth place, and congenital malformations, deformities, and chromosomal abnormalities decreased from third place to eighth place. Among the top ten deadly diseases, severe pneumonia ranked first in all three periods; acute lymphoblastic leukemia increased from ninth place in 2009—2013 to third place in 2019—2023. The leading cause of death during the neonatal period was neonatal respiratory failure, while the leading cause of death during infancy, early childhood, preschool, and school years was severe pneumonia. The leading cause of death during adolescence was cavernous sinus abscess.
Conclusion The mortality rate of hospitalized children in Tianjin has decreased from 2009 to 2023. Clinical and preventive work in pediatrics should continue to focus on critically ill children with severe pneumonia sepsis, as well as diseases such as cavernous sinus abscesses. At the same time, efforts should be made to strengthen the prevention and control of the circulatory system, certain infectious and parasitic diseases, accidental injuries, and malignant tumors, to reduce the mortality rate of hospitalized children.
1.王心雨, 曾跃萍, 宋菲, 等. 22家三级甲等儿童医院住院儿童疾病和死亡外因流行病学分析[J]. 疾病监测, 2020, 35(12): 1141-1145. [Wang XY, Zeng YP, Song F, et al. An epidemiological analysis on external causes of morbidity and mortality for hospitalized children in 22 grade Ⅲ (A) children's hospitals[J]. Disease Surveillance, 2020, 35(12): 1141-1145.] DOI: 10.3784/j.issn.1003-9961. 2020.12.017.
2.仝岚. 2005—2019年江苏省昆山市儿童青少年死亡率趋势分析[J]. 中国妇幼卫生杂志, 2021, 12(6): 52-55. [Tong L. Trend analysis of child and adolescent mortality in Kunshan, Jiangsu, 2005—2019[J]. Chinese Journal of Women and Children Health, 2021, 12(6): 52-55.] DOI: 10.19757/j.cnki.issn 1674-7763.2021.06.012.
3.韩丹,高红霞,候贵林. 政策工具视角下《健康中国行动(2019—2030年)》政策分析[J]. 医学与社会, 2020, 33(11): 20-24. [Han D, Gao HX, Hou GL. Analysis of Healthy China Action (2019—2030) based on the perspective of policy tools[J]. Medicine and Society, 2020, 33(11): 20-24.] DOI: 10.13723/j.xysh.2020.11.004.
4.叶璐熳,宋萍,马武琼. 2007—2021年某院住院患儿死亡疾病谱分析[J]. 现代医药卫生, 2023, 39(6): 953-959. [Ye LM, Song P, Ma WQ. Analysis of death spectrum of children in a hospital from 2007 to 2021[J]. Journal of Modern Medicine & Health, 2023, 39(6): 953-959.] DOI: 10.3969/j.issn.1009-5519.2023.06.013.
5.贾林斌, 李帅奇, 王栋, 等. 2000—2020年河南省5岁以下儿童死亡情况分析[J]. 现代预防医学, 2023, 50(6): 1063-1068. [Jia LB, Li SQ, Wang D, et al. Analysis of under-5 mortality in Henan, 2000—2020[J]. Modern Preventive Medicine, 2023, 50(6): 1063-1068.] DOI: 10.20043/j.cnki.MPM.202205562.
6.国家卫生健康委员会. 国家卫生健康委员会2024年5月31日新闻发布会文字实录. [2024-05-31] (2024-06-10). http://www.nhc.gov.cn/xcs/s3574/202405/83bea619368c417b81e6d27f47f165ea.shtml.
7.李丽静, 李媛媛, 张玉琴, 等. 2000—2009年天津市儿童医院住院患儿病死率及病死原因分析[J]. 中国实用儿科杂志, 2011, 26(1): 55-57. [Li LJ, Li YY, Zhang YQ, et al. Analysis of the mortality rate and causes of inpatient children in Tianjin Children's Hospital from 2000 to 2009[J]. Chinese Journal of Practical Pediatrics, 2011, 26(1): 55-57.] DOI: 10.1007/s12583-011-0153-1.
8.Zhang M, Qu HM, Xia JF, et al. Trends, influencing factors and prediction analysis of under-five and maternal mortality rates in China from 1991 to 2020[J]. Front Public Health, 2023, 11: 1198356. DOI: 10.3389/FPUBH. 2023.1198356.
9.周彬, 陈柳珊. 珠海市某医院儿科住院患儿20年疾病谱变化规律研究[J]. 中国病案, 2020, 21(6): 61-62, 112. [Zhou B, Chen LS. Study on the changes of disease spectrum of pediatricinpatients in a hospital in Zhuhai for 20 years[J]. Chinese Medical Records, 2020, 21(6): 61-62, 112.] DOI: 10.3969/j.issn.1672-2566.2020.06.023.
10.明建军,杨巧玲,孙华君,等. 环丙沙星治疗儿童耐大环内酯类支原体肺炎的回顾性分析[J]. 药物流行病学杂志, 2022, 31(12): 803-807. [Ming JJ, Yang QL, Sun HJ, et al. Retrospective analysis of ciprofloxacin in the treatment of children with macrolide-resistant Mycoplasma pneumoniae pneumonia[J]. Chinese Journal of Pharmacoepidemiology, 2022, 31(12): 803-807.] DOI: 10.19960/j.cnki.issn1005-0698.2022.12.004.
11.戴萌娜,袭燕,尹文强,等. 中国2005—2019年0~14 岁儿童肺炎死亡趋势分析[J]. 中国学校卫生, 2021, 42(9): 1411-1414. [Dai MN, Xi Y, Yin WQ, et al. Pneumonia mortality in children aged 0-14 years in China during 2005 to 2019[J]. Chinese Journal of School Health, 2021, 42(9): 1411-1414.] DOI: 10.16835/j.cnki.1000-9817.2021.09.033.
12.Emily KN, Claire S, Matthew PS, et al. Taxonomy of pathogen codetection in pediatric case fatalities with adenoviral respiratory infection[J]. Pediatr Infect Dis, 2021, 16(5): 194-199. DOI: 10.1055/S-0041-1731409.
13.林韵, 林隽宇, 李晓君. 广州市某医院2011—2020年住院儿童死亡病例统计分析[J]. 中国卫生统计, 2023, 40(4): 598-600, 604. [Lin Y, Lin JY, Li XJ. Statistical analysis of inpatient child mortality cases in a hospital in Guangzhou from 2011 to 2020[J]. Chinese Journal of Health Statistics, 2023, 40(4): 598-600, 604.] DOI: 10.11783/j.issn.1002-3674.2023.04.030.
14.戴志军. 某儿童医院住院患儿死亡病例分析[J]. 中国病案, 2023, 24(4): 54-57. [Dai ZJ. Analysis of death cases of hospitalized children in a children's hospital[J]. Chinese Medical Record, 2023, 24(4): 54-57.] DOI: 10.3969/j.issn.1672-2566.2023.04.020.
15.Cheng XF, Wang HZ, Sun LL, et al. Construction and external validation of a scoring prediction model for mortality risk within 30 days of community-acquired pneumonia in children admitted to the pediatric intensive care unit: a multicenter retrospective case-control study[J]. Medicine (Baltimore), 2024, 103(10): e37419.] DOI: 10.1097/MD.0000000000037419.
16.屈芳,王美艳,魏选东,等. 2003年—2017年某院住院儿童死亡疾病谱分析[J]. 中国病案, 2021, 22(2): 62-65. [Qu F, Wang MY, Wei XD, et al. Analysis of the characteristics of death spectrum of hospitalized children in a hospital from 2003 to 2017[J]. Chinese Medical Record, 2021, 22(2): 62-65.] DOI: 10.3969/j.issn.1672-2566.2021.02.022.
17.国家卫生健康委员会. 关于印发儿童社区获得性肺炎诊疗规范(2019年版)的通知[EB/OL]. (2019-02-01)[2024-07-19]. http://www.nhc.gov.cn/yzygj/s7653/201902/bfa758ad6add48a599bc74b588a6e89a.shtml.
18.Mameli C, Genoni T, Madia C, et al. Brain abscess in pediatric age: a review[J]. Childs Nerv Syst, 2019, 35(7): 1117-1128. DOI: 10.1007/s00381-019-04182-4.
19.王仲, 于学忠, 陈玉国, 等. 中国脓毒症早期预防与阷断急诊专家共识[J]. 实用休克杂志(中英文), 2020, 4(3): 168-177. [Wang Z, Yu XZ, Chen YG, et al. Chinese expert consensus on early prevention and intervention of sepsis[J]. Journal of Practical Shock, 2020, 4(3): 168-177.] http://qikan.cqvip.com/Qikan/Article/Detail?id=00002FCD47407JP0MPDO6JP16NR&from=Qikan_Search_Index.
20.张学鹏, 吉毅, 陈思源. 拯救脓毒症运动儿童脓毒性休克和脓毒症相关器官功能障碍国际指南解读[J]. 中国当代儿科杂志, 2020, 22(4): 305-309. [Zhang XP, Ji Y, Chen SY. Interpretation on the "surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children"[J]. Chinese Journal of Contemporary Pediatrics, 2020, 22(4): 305-309.] DOI: 10.7499/j.issn.1008-8830.2003005.
21.国家卫生健康委员会. 关于印发儿童急性淋巴细胞白血病、儿童急性早幼粒细胞白血病诊疗规范(2018年版)的通知[EB/OL]. (2018-10-8) [2024-07-19]. http://www.nhc.gov.cn/yzygj/s7653/201810/aef82930c1af4fc5bf325938e2fcb075.shtml.