Department of Pediatrics, NHO Okayama Medical Center, Okayama, Japan.
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Paediatr Perinat Epidemiol. 2024 Nov;38(8):692-699. doi: 10.1111/ppe.13116. Epub 2024 Sep 3.
Adverse effects of medical treatment (AEMT) pose significant risks to paediatric patients. However, the mortality trends associated with AEMT in this population have been unclear.
We aimed to clarify the trends in the incidence, disability-adjusted life years (DALYs) and mortality rates of AEMT for children in the US from 2000 to 2019.
Data were retrieved from the Global Burden of Disease study 2019. We estimated age-standardized incidence, DALYs and mortality rates of paediatric AEMT per 100,000 children in the US using a Bayesian meta-regression model. We also analysed incidence, DALYs and mortality in different age groups, and employed Joinpoint regression models to assess the age- and sex-specific trends.
The number of deaths due to AEMT in children, the number of cases, and DALYs were 105.1, 551,076 and 145,555 in 2019, decreased by 37.5%, 6% and 28% from those in 2000, respectively. Age-standardized mortality rates decreased across all age groups, while the incidence increased across all age groups with an average annual percentage change (AAPC) of 2.2% in those children <1 year and 4.5% in 5-9 years of age. The increases in DALYs over time was higher in children aged 1-4 years (AAPC: 0.51, 95% CI: 0.47, 0.62) and 5-9 years (AAPC: 0.33, 95% CI: 0.15, 0.50), with the 1-4 year age group being the highest.
The study reveals declining AEMT mortality but rising incidence and DALYs, emphasizing a disproportionate burden in <1, 1-4 and 5-9 years. To develop effective mitigation strategies, future research is warranted to identify the causes of increased AEMT in children, especially young males.
医疗不良事件（AEMT）对儿科患者构成重大风险。然而，该人群中与 AEMT 相关的死亡率趋势尚不清楚。
我们旨在阐明 2000 年至 2019 年美国儿童 AEMT 的发病率、残疾调整生命年（DALYs）和死亡率趋势。
数据来自 2019 年全球疾病负担研究。我们使用贝叶斯荟萃回归模型估计了美国每 10 万名儿童 AEMT 的年龄标准化发病率、DALYs 和死亡率。我们还分析了不同年龄组的发病率、DALYs 和死亡率，并使用 Joinpoint 回归模型评估了年龄和性别特定的趋势。
2019 年，儿童 AEMT 死亡人数、病例数和 DALYs 分别为 105.1、551076 和 145555，较 2000 年分别下降 37.5%、6%和 28%。所有年龄组的年龄标准化死亡率均下降，而所有年龄组的发病率均增加，<1 岁儿童的年均百分比变化（AAPC）为 2.2%，5-9 岁儿童为 4.5%。随着时间的推移，1-4 岁（AAPC：0.51，95%CI：0.47，0.62）和 5-9 岁（AAPC：0.33，95%CI：0.15，0.50）儿童的 DALYs 增加幅度更高，1-4 岁年龄组最高。
研究显示 AEMT 死亡率下降，但发病率和 DALYs 上升，表明<1 岁、1-4 岁和 5-9 岁儿童的负担不成比例。为制定有效的缓解策略，未来的研究需要确定导致儿童 AEMT 增加的原因，特别是年轻男性。
