Socioeconomic background affects mortality in Danish children with severe chronic disease

Jensen, Anne K.; Greisen, Gorm; Stensballe, Lone Graff

doi:10.1111/apa.16540

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…19 In contrast, another population-based study from Denmark, reporting on mortality risks in children with severe chronic diseases, did not find sex differences in mortality risk. 20 However, they reported a higher mortality risk associated with lowincome families, both while admitted and in the post-discharge setting, in line with our results.…”

Section: Discussionsupporting

confidence: 91%

“…The higher mortality risk in males was also seen in the reference population and has previously been reported in the general population in a study including all individuals born in Denmark from 1980 to 2015 19 . In contrast, another population‐based study from Denmark, reporting on mortality risks in children with severe chronic diseases, did not find sex differences in mortality risk 20 . However, they reported a higher mortality risk associated with low‐income families, both while admitted and in the post‐discharge setting, in line with our results.…”

Section: Discussionsupporting

confidence: 77%

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Paediatric‐onset immune‐mediated inflammatory disease is associated with an increased mortality risk—A nationwide study

Malham,

Jansson,

Ingels

et al. 2024

Aliment Pharmacol Ther

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SummaryBackgroundPaediatric‐onset immune‐mediated inflammatory diseases (pIMID) show more aggressive phenotypes than when diagnosed in adults. However, data on mortality are often extrapolated from adult studies.AimTo estimate the effect of pIMID on mortality.MethodsIn a population‐based cohort study using the nationwide Danish healthcare registers, we included all patients diagnosed with pIMID in Denmark from 1980 to 2018. PIMID were defined as ICD codes indicative of autoimmune hepatitis, primary sclerosing cholangitis, Crohn's disease, ulcerative colitis, juvenile idiopathic arthritis, lupus erythematosus, or vasculitis registered before age 18 years. All‐cause mortality was the primary outcome; cause‐specific mortality was the secondary outcome. We used Cox survival analysis to estimate hazard ratios (HR), and Aalen survival analysis to estimate rate differences.ResultsWe included 11,581 individuals diagnosed with pIMID and 99,665 reference individuals, accounting for 1,371,994 person‐years of follow‐up. Median and interquartile (IQR) age at diagnosis was 12.6 (7.9–15.9) years. During follow‐up, 152 patients with pIMID and 316 reference individuals died; adjusted HR (aHR) was 3.8 (95% confidence interval [CI] 3.1–4.7). This corresponded to 6.9 (95% CI: 5.3–8.5) additional deaths per 10,000 person‐years. The strongest associations were found for gastrointestinal diseases (aHR 22.8; 95% CI 9.6–64.1), gastrointestinal cancers (aHR 19.2; 95% CI 5.0–74.2) and lymphoproliferative disorders (aHR 6.8; 95% CI 2.8–16.8).ConclusionPatients diagnosed with pIMID have a fourfold higher risk of mortality when followed into early adulthood compared with reference individuals. This underlines the severe disease course of pIMID and highlights the need for multidisciplinary care.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 77%

Paediatric‐onset immune‐mediated inflammatory disease is associated with an increased mortality risk—A nationwide study

Malham,

Jansson,

Ingels

et al. 2024

Aliment Pharmacol Ther

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“…The results are presented by calendar year as totals and by sex (female, male), age group (< 28 days, 28–365 days, 1–5 years) and chronic disease status (yes, no). The definition of chronic disease is described in prior studies [ 2 , 12 , 13 ]. In the present study it was included as a time-varying variable with the status updated at the beginning of each calendar year.…”

Section: Methodsmentioning

confidence: 99%

Surgical procedures in Danish children 1999–2018

Jensen¹,

Greisen²,

Hjuler³

et al. 2023

PLoS ONE

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Objective To assess if the overall utilisation of surgery in Danish children 0–5 years of age increased in the period 1999–2018 in line with the development within specialised medical services. The epidemiology on surgical procedures is scarce. Methods National register-based cohort study of all Danish children born 1994–2018 (n = 1,599,573) using data on surgery in public and private hospitals from The National Patient Register and data on surgery in private specialist practice from The Health Service Register. Incidence rate ratios were calculated using Poisson regression with 1999 as the reference year. Results During the study period 115,573 different children (7.2% of the cohort) underwent surgery. The overall incidence of surgical procedures was stable, but the use of surgery increased in neonates mainly due to an increase in frenectomy. Boys underwent more surgery than girls. In children with severe chronic disease the rate of surgery decreased in public hospitals and increased in private specialist practices. Conclusion The utilisation of surgical procedures in Danish children 0–5 years of age did not increase from 1999 to 2018. The use of available register data in the present study may inspire surgeons to conduct further studies to enhance the knowledge within the area of surgical procedures.

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Socioeconomic background affects mortality in Danish children with severe chronic disease

2022

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A previous study found that socioeconomic factors affected the all-cause mortality rate in otherwise healthy Danish children. 1 The present study concerns children diagnosed with a severe, potentially life-threatening, chronic disease. When it comes to reducing mortality in patients with life-threatening disease the conventional focus is on healthcare quality. This leads to the introduction of ever more highly specialised treatments with the ambition of improving the quality of diagnosis and treatment. 2-4 However, little is known about the influence of socioeconomic factors on mortality and even less is known about the potential benefits of socioeconomic interventions.Previous studies on the association between socioeconomic factors and cancer survival in Danish children highlighted these aspects. 5,6

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Socioeconomic background affects mortality in Danish children with severe chronic disease

Cited by 3 publications

References 16 publications

Paediatric‐onset immune‐mediated inflammatory disease is associated with an increased mortality risk—A nationwide study

Paediatric‐onset immune‐mediated inflammatory disease is associated with an increased mortality risk—A nationwide study

Surgical procedures in Danish children 1999–2018

Socioeconomic background affects mortality in Danish children with severe chronic disease

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