Cause-specific child and adolescent mortality in the UK and EU15+ countries

Wolfe, Ingrid; Viner, Russell

doi:10.1136/archdischild-2019-318097

Cited by 11 publications

(9 citation statements)

References 22 publications

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“…The bigger group of patients was without congenital impairment and the smaller group was affected by congenital impairment. The heterogeneity in death cases was different ( 42 , 43 ). The majority of death cases may be related to congenital impairment, which was latent.…”

Section: Discussionmentioning

confidence: 99%

Why Does Child Mortality Decrease With Age? Modeling the Age-Associated Decrease in Mortality Rate Using WHO Metadata From 25 Countries

Dolejs

Homolková

2021

Front. Pediatr.

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Background: Our previous study analyzed the age trajectory of mortality (ATM) in 14 European countries, while this study aimed at investigating ATM in other continents and in countries with a higher level of mortality. Data from 11 Non-European countries were used.Methods: The number of deaths was extracted from the WHO mortality database. The Halley method was used to calculate the mortality rates in all possible calendar years and all countries combined. This method enables us to combine more countries and more calendar years in one hypothetical population.Results: The age trajectory of total mortality (ATTM) and also ATM due to specific groups of diseases were very similar in the 11 non-European countries and in the 14 European countries. The level of mortality did not affect the main results found in European countries. The inverse proportion was valid for ATTM in non-European countries with two exceptions.Slower or no mortality decrease with age was detected in the first year of life, while the inverse proportion model was valid for the age range (1, 10) years in most of the main chapters of ICD10.Conclusions: The decrease in child mortality with age may be explained as the result of the depletion of individuals with congenital impairment. The majority of deaths up to the age of 10 years were related to congenital impairments, and the decrease in child mortality rate with age was a demonstration of population heterogeneity. The congenital impairments were latent and may cause death even if no congenital impairment was detected.

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Section: Discussionmentioning

confidence: 99%

Why Does Child Mortality Decrease With Age? Modeling the Age-Associated Decrease in Mortality Rate Using WHO Metadata From 25 Countries

Dolejs

Homolková

2021

Front. Pediatr.

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“…Health system performance assessment and comparative studies have been increasing since the World Health Report in 2000 [16] and methods have been developed to suit the complexities of health systems research [17]. However, there has been less focus on children in health systems, particularly among high income countries with less pronounced problems than among low-and middle-income countries, but where important questions about disparities in high level outcomes such as child survival remain unanswered [18][19][20].…”

Section: The Value and Application Of Current Health System Performan...mentioning

confidence: 99%

COVID-19 has exposed the need for health system assessments to be more child health-sensitive

et al. 2022

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T he COVID-19 pandemic is directly and indirectly impacting children's health [1]. Although the evidence base in this area is expanding, there is still much we do not know. Paediatric Multisystem Inflammatory Syndrome temporally associated with COVID-19 (MIS-C: Multisystem Inflammatory Syndrome -Children) and long COVID are the most notable direct effects of COVID-19 infection on children [2,3], though they are rare [4]. Data suggest that children represent a very low proportion (between 1 and 3% of the total) among known COVID-19 infections, at least in the early stages of the COVID-19 pandemic [5]. However, because children are likely to have a higher proportion of asymptomatic infection than adults [6], this might be an underestimation. The most significant population-level health harms for children from the pandemic are indirect, reflecting the impact of health system adaptations and policy changes [1,7] such as elective care postponement and cancellation and possibly remote (instead of face-to-face) consultation which remains unevaluated. Evidence is emerging from a variety of different countries, illustrating the breadth of problems. In England, a large national longitudinal study found an increase in the rates of probable mental health disorders among children aged 5-16 before (10.8% in 2017) and after (16% in 2020) the pandemic. However, more than a fifth of children and 44.6% of 17-22-year-olds with a probable mental health disorder did not seek mental health service support due to the pandemic [8]. Similarly, a very stark drop in accident and emergency attendances for mental health problems during and after the first COVID-19 policy measures and a steep rise in the first months of 2021 were reported in Scotland [9]. Emergency Department contacts among children in England fell to 40%

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“…The UK has a higher medical mortality in the young than the European average for preventable deaths from common infections and respiratory conditions. 1 Evidence suggests missing early deterioration and variation in responses to deterioration can contribute to this. 2 The reasons why early deterioration in children is missed, can be grouped into themes: 3 ► Systems failure issues, for example, staffing number and skill mix, multiple simultaneous demands.…”

Section: Introductionmentioning

confidence: 99%

Case for change: a standardised inpatient paediatric early warning system in England

et al. 2021

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Most children in hospital who are clinically deteriorating are monitored regularly, and their treatment is escalated effectively. However a small, but significant, number of deteriorating children experience suboptimal outcomes because of a failure to recognise and respond to acute deterioration early enough leading to unintended harm. Tragically this occasionally can have fatal consequences. Investigations into these rare events highlight common themes of missed early signs of deterioration in children, prompting regulatory agencies to suggest paediatric early warning systems (PEWS) to aid clinical practice. In England, track and trigger tools (TTT), which are one facet of PEWS have been widely rolled out but in a heterogeneous fashion. The evidence for TTT is mixed but they are complex interventions and current outcomes do not fully define the entirety of their potential impact. This article explains the rationale behind the decision of the NHS England and NHS Improvement, Royal College of Paediatrics and Child Health and Royal College of Nursing to implement a standardised inpatient PEWS as part of a system-wide paediatric observations tracking system in England and how this fits into a wider programme of activity.

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Cause-specific child and adolescent mortality in the UK and EU15+ countries

Cited by 11 publications

References 22 publications

Why Does Child Mortality Decrease With Age? Modeling the Age-Associated Decrease in Mortality Rate Using WHO Metadata From 25 Countries

Why Does Child Mortality Decrease With Age? Modeling the Age-Associated Decrease in Mortality Rate Using WHO Metadata From 25 Countries

COVID-19 has exposed the need for health system assessments to be more child health-sensitive

Case for change: a standardised inpatient paediatric early warning system in England

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