Department of Paediatric Emergency, UHC Mohamed VI, Cadi Ayyad University, PO Box: 7010, Sidi Abbad Street, 40000, Marrakech, Morocco.
BMC Emerg Med. 2020 Jul 23;20(1):57. doi: 10.1186/s12873-020-00352-9.
The death of a child at the emergency ward is one of the most difficult problems that the clinicians of these wards have to deal with. In our country the published data concerning the causes and the factors related to pediatric mortality especially in the pediatric emergency wards is very rare. This study aimed to study the epidemiology of the pediatric mortality in the pediatric emergency department (PED), to determine its rate and identify its most frequent causes.
It is a retrospective and descriptive study, over five years (1st January 2012 and 31st December 2016) including all children aged from 0 to 15 years old who died at the PED in the Mohamed VI Hospital in Marrakech.
During the period of the study a total of 172.691 patients presented to the PED, among which 628 died (pediatric mortality rate: 3.63%). The masculine gender was predominant (n = 383) with a gender ratio of 1.59. Two-thirds of the patients died in the first 24 h (n = 421). The median of time from admission to death was around 12 h. Majority of the deceased children (n = 471, 75%) were from a low socioeconomic status. The most frequent cause of admissions for deceased patients in the PED was respiratory distress (n = 296, 47%) followed by neurological disorders (n = 70, 11%). Neonatal mortality (≤ 1 month of age) was predominant (n = 472, 75.1%), followed by postnatal mortality (1 month to 1 year old) (n = 73, 11.6%). The most frequent causes of pediatric mortality, whatever the age range, were dominated by neonatal pathologies (n = 391, 62.3%), followed by infecious causes bronchopulmonary infections included (n = 49, 7.7%), birth deformities (n = 46, 7.3%) while traumas were merely at 0.9% (n = 6). The most frequent causes of neonatal mortality were neonatal infections (n = 152, 32.2%) and prematurity (n = 115, 24.4%).
Our data once again underline the crucial importance of prevention. This requires correct follow-up of the pregnancies, an adequate assistance of births, and perfecting healthcare provision to newborns in order to attain proper assistance.
在急诊病房，儿童死亡是该病房临床医生必须处理的最困难问题之一。在我国，有关儿科死亡率的原因和相关因素的已发表数据，特别是在儿科急诊病房中非常罕见。本研究旨在研究儿科急诊部（PED）儿科死亡率的流行病学，确定其发生率并确定其最常见的原因。
这是一项回顾性和描述性研究，为期五年（2012 年 1 月 1 日至 2016 年 12 月 31 日），包括在马拉喀什穆罕默德六世医院 PED 死亡的所有 0 至 15 岁的儿童。
在研究期间，共有 172691 名患者到 PED 就诊，其中 628 人死亡（儿科死亡率：3.63%）。男性居多（n=383），性别比为 1.59。三分之二的患者在 24 小时内死亡（n=421）。从入院到死亡的中位数时间约为 12 小时。大多数死亡儿童（n=471，75%）来自低社会经济地位。PED 住院死亡患者最常见的原因是呼吸窘迫（n=296，47%），其次是神经系统疾病（n=70，11%）。新生儿死亡（≤1 个月）为主（n=472，75.1%），其次是围产期死亡（1 个月至 1 岁）（n=73，11.6%）。无论年龄范围如何，儿科死亡率的最常见原因均以新生儿疾病为主（n=391，62.3%），其次是感染性病因（包括支气管肺部感染）（n=49，7.7%），出生畸形（n=46，7.3%），而创伤仅占 0.9%（n=6）。新生儿死亡的最常见原因是新生儿感染（n=152，32.2%）和早产（n=115，24.4%）。
我们的数据再次强调了预防的重要性。这需要正确的妊娠随访，适当的分娩协助，并完善新生儿保健服务，以获得适当的帮助。
