Sherman Y, Matthew D J, Boyd R D
Arch Dis Child. 1983 Nov;58(11):872-7. doi: 10.1136/adc.58.11.872.
There were 131 deaths among children aged between birth and 14 years during a period of 18 months in one inner London area health authority. One hundred children died in hospital, 23 at home, and 8 elsewhere. Thirty three died of congenital, 46 of perinatal, and 34 of other medical causes. There were 18 violent deaths--16 among children over 1 year of age. Medical and social information, collected from analysis of records and interview with those involved, was considered by a review panel and the following conclusions were drawn: there was scope for prevention of congenital disease or malformation in only one of 33 cases; with routine pathological investigation the cause of death in postperinatal infancy was usually unclear--more detailed pathological investigation should be routinely available for the investigation of deaths in the first year of life; there were possible management failures in four of 8 non-malignant medical deaths in older children; malignant disease was promptly diagnosed; fatal accidents were almost entirely restricted to the children of families under marked psychosocial stress; and there was some evidence of faulty communication between health agencies and of the inappropriate routing of emergency admissions.
在伦敦市中心一个地区的卫生当局管辖范围内，18个月期间有131名14岁及以下儿童死亡。其中100名儿童死于医院，23名死于家中，8名死于其他地方。33名死于先天性疾病，46名死于围产期疾病，34名死于其他医学原因。有18例暴力死亡——其中16例发生在1岁以上儿童中。审查小组研究了通过记录分析和与相关人员访谈收集到的医学和社会信息，并得出以下结论：在33例先天性疾病或畸形病例中，只有1例存在预防空间；常规病理检查后，围产期后婴儿的死因通常不明——对于1岁以内婴儿死亡的调查，应常规提供更详细的病理检查；在8例大龄儿童非恶性医学死亡病例中，有4例可能存在治疗失误；恶性疾病能得到及时诊断；致命事故几乎都发生在承受明显社会心理压力家庭的儿童中；有证据表明卫生机构之间存在沟通不畅以及紧急入院转诊不当的情况。
