中国住院儿童感染相关死亡率：一项2016年至2021年的多中心研究。
Infection-related mortality in hospitalized children: A multi-center study in China from 2016 to 2021.
作者信息
Tian Jiao, Li Qi, Cai Shiqi, Wang Xinyu, Ai Junhong, Feng Guoshuang, Zeng Yueping, Wang Ran, Xie Zhengde
机构信息
Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Beijing, China; Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China; Department of Respiratory, Tianjin Children's Hospital, Tianjin, China.
Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Beijing Key Laboratory of Core Technologies for the Prevention and Treatment of Emerging Infectious Diseases in Children, Beijing, China; Research Unit of Critical Infection in Children, 2019RU016, Chinese Academy of Medical Sciences, Beijing, China; Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, Liaoning, China.
出版信息
J Infect Public Health. 2025 Jun;18(6):102743. doi: 10.1016/j.jiph.2025.102743. Epub 2025 Mar 6.
BACKGROUND
Hospitalized children experience mortality as a result of infections. Since the COVID-19 outbreak in early 2020, China's strict prevention measures have curbed pathogen transmission, altering infection-related epidemiology. The Futang Research Center of Pediatric Development has collected the face sheet of discharge medical records (FSMRs) data from 27 tertiary children's hospitals since January 2016, which facilitate us to investigate this issue. Moreover, this study focuses on hospitalized children aged 18 years old or younger.
METHODS
This study analyzed data from the FSMRs of children who died from infections at 27 tertiary children's hospitals across China between January 2016 and December 2021. Of these hospitals, 21 are located in provincial capitals. The data included gender, age, region, residence, year of admission, infections-associated causes of death, pathogens, length of stay, and expense.
RESULTS
A total of 1130 hospitalized children died from infections, accounting for 18.8 % of all deaths and 0.015 % of the total hospitalizations in the database during the period. Boys had a higher fatality than girls across different regions, age groups, years. Among all age groups, 0-28 days and 29 days-1 year group (≤365 days) had a higher number and proportion of deaths than other age groups. In terms of year of admission, the COVID-19 period (2020-2021) had a lower number of infections related death cases than pre-COVID-19 period. Further analysis of infection-related causes indicated that sepsis was the most common cause of death, followed by pneumonia, central nervous system infection, shock, enteritis, and myocarditis. The pathogens (bacterium, virus, fungus) were identified in 30.6 % of children.
CONCLUSIONS
Infections are the significant cause of death among hospitalized children in China.
背景
住院儿童会因感染而死亡。自2020年初新冠疫情爆发以来，中国严格的预防措施遏制了病原体传播，改变了与感染相关的流行病学情况。自2016年1月起，福棠儿童发展研究中心收集了27家三级儿童医院出院病历首页（FSMRs）数据，这有助于我们调查此问题。此外，本研究聚焦于18岁及以下的住院儿童。
方法
本研究分析了2016年1月至2021年12月期间中国27家三级儿童医院中因感染死亡儿童的FSMRs数据。这些医院中，21家位于省会城市。数据包括性别、年龄、地区、居住地、入院年份、感染相关死因、病原体、住院时长及费用。
结果
共有1130名住院儿童死于感染，占该时期数据库中所有死亡人数的18.8%，占总住院人数的0.015%。在不同地区、年龄组和年份中，男孩的死亡率高于女孩。在所有年龄组中，0 - 28天和29天至1岁组（≤365天）的死亡人数和比例高于其他年龄组。就入院年份而言，新冠疫情期间（2020 - 2021年）感染相关死亡病例数低于新冠疫情前时期。对感染相关病因的进一步分析表明，脓毒症是最常见的死因，其次是肺炎、中枢神经系统感染、休克、肠炎和心肌炎。30.6%的儿童中鉴定出了病原体（细菌、病毒、真菌）。
结论
感染是中国住院儿童死亡的重要原因。
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