Deaths Attributed to Pediatric Complex Chronic Conditions: National Trends and Implications for Supportive Care Services
Children with complex chronic conditions (CCCs) might benefit from pediatric supportive care services, such as home nursing, palliative care, or hospice, especially those children whose conditions are severe enough to cause death. We do not know, however, the extent of this population or how it is c...
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| Veröffentlicht in: | Pediatrics (Evanston) 2001-06, Vol.107 (6), p.e99-e99 |
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| creator | Feudtner, Chris Hays, Ross M Haynes, Gerri Geyer, J. Russell Neff, John M Koepsell, Thomas D |
| description | Children with complex chronic conditions (CCCs) might benefit from pediatric supportive care services, such as home nursing, palliative care, or hospice, especially those children whose conditions are severe enough to cause death. We do not know, however, the extent of this population or how it is changing over time.
To identify trends over the past 2 decades in the pattern of deaths attributable to pediatric CCCs, examining counts and rates of CCC-attributed deaths by cause and age (infancy: |
| doi_str_mv | 10.1542/peds.107.6.e99 |
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To identify trends over the past 2 decades in the pattern of deaths attributable to pediatric CCCs, examining counts and rates of CCC-attributed deaths by cause and age (infancy: <1 year old, childhood: 1-9 years old, adolescence or young adulthood: 10-24 years old) at the time of death, and to determine the average number of children living within the last 6 months of their lives.
We conducted a retrospective cohort study using national death certificate data and census estimates from the National Center for Health Statistics. Participants included all people 0 to 24 years old in the United States from 1979 to 1997. CCCs comprised a broad array of International Classification of Diseases, Ninth Revision codes for cardiac, malignancy, neuromuscular, respiratory, renal, gastrointestinal, immunodeficiency, metabolic, genetic, and other congenital anomalies. Trends of counts and rates were tested using negative binomial regression.
Of the 1.75 million deaths that occurred in 0- to 24-year-olds from 1979 to 1997, 5% were attributed to cancer CCCs, 16% to noncancer CCCs, 43% to injuries, and 37% to all other causes of death. Overall, both counts and rates of CCC-attributed deaths have trended downward, with declines more pronounced and statistically significant for noncancer CCCs among infants and children, and for cancer CCCs among children, adolescents, and young adults. In 1997, deaths attributed to all CCCs accounted for 7242 infant deaths, 2835 childhood deaths, and 5109 adolescent deaths. Again, in 1997, the average numbers of children alive who would die because of a CCC within the ensuing 6-month period were 1097 infants, 1414 children, and 2548 adolescents or young adults.
Population-based planning of pediatric supportive care services should use measures that best inform our need to provide care for time-limited events (perideath or bereavement care) versus care for ongoing needs (home nursing or hospice). Pediatric supportive care services will need to serve patients with a broad range of CCCs from infancy into adulthood.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.107.6.e99</identifier><identifier>PMID: 11389297</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: Am Acad Pediatrics</publisher><subject>Adolescent ; Adult ; Cause of Death ; Child ; Chronic Disease - epidemiology ; Chronic Disease - mortality ; Female ; Humans ; Male ; Mortality - trends ; Pediatrics ; Pediatrics - statistics & numerical data ; United States - epidemiology</subject><ispartof>Pediatrics (Evanston), 2001-06, Vol.107 (6), p.e99-e99</ispartof><rights>Copyright National Library of Medicine - MEDLINE Abstracts Jun 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-dcfd797de225bb4339f2c0625ea17e36475bcfd865e07e324f70588559aed7f73</citedby><cites>FETCH-LOGICAL-c397t-dcfd797de225bb4339f2c0625ea17e36475bcfd865e07e324f70588559aed7f73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11389297$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feudtner, Chris</creatorcontrib><creatorcontrib>Hays, Ross M</creatorcontrib><creatorcontrib>Haynes, Gerri</creatorcontrib><creatorcontrib>Geyer, J. Russell</creatorcontrib><creatorcontrib>Neff, John M</creatorcontrib><creatorcontrib>Koepsell, Thomas D</creatorcontrib><title>Deaths Attributed to Pediatric Complex Chronic Conditions: National Trends and Implications for Supportive Care Services</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Children with complex chronic conditions (CCCs) might benefit from pediatric supportive care services, such as home nursing, palliative care, or hospice, especially those children whose conditions are severe enough to cause death. We do not know, however, the extent of this population or how it is changing over time.
To identify trends over the past 2 decades in the pattern of deaths attributable to pediatric CCCs, examining counts and rates of CCC-attributed deaths by cause and age (infancy: <1 year old, childhood: 1-9 years old, adolescence or young adulthood: 10-24 years old) at the time of death, and to determine the average number of children living within the last 6 months of their lives.
We conducted a retrospective cohort study using national death certificate data and census estimates from the National Center for Health Statistics. Participants included all people 0 to 24 years old in the United States from 1979 to 1997. CCCs comprised a broad array of International Classification of Diseases, Ninth Revision codes for cardiac, malignancy, neuromuscular, respiratory, renal, gastrointestinal, immunodeficiency, metabolic, genetic, and other congenital anomalies. Trends of counts and rates were tested using negative binomial regression.
Of the 1.75 million deaths that occurred in 0- to 24-year-olds from 1979 to 1997, 5% were attributed to cancer CCCs, 16% to noncancer CCCs, 43% to injuries, and 37% to all other causes of death. Overall, both counts and rates of CCC-attributed deaths have trended downward, with declines more pronounced and statistically significant for noncancer CCCs among infants and children, and for cancer CCCs among children, adolescents, and young adults. In 1997, deaths attributed to all CCCs accounted for 7242 infant deaths, 2835 childhood deaths, and 5109 adolescent deaths. Again, in 1997, the average numbers of children alive who would die because of a CCC within the ensuing 6-month period were 1097 infants, 1414 children, and 2548 adolescents or young adults.
Population-based planning of pediatric supportive care services should use measures that best inform our need to provide care for time-limited events (perideath or bereavement care) versus care for ongoing needs (home nursing or hospice). Pediatric supportive care services will need to serve patients with a broad range of CCCs from infancy into adulthood.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Cause of Death</subject><subject>Child</subject><subject>Chronic Disease - epidemiology</subject><subject>Chronic Disease - mortality</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mortality - trends</subject><subject>Pediatrics</subject><subject>Pediatrics - statistics & numerical data</subject><subject>United States - epidemiology</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtv3CAURlHUqpmk3WZZoS66s8vDGJNd5DQPKWorJV0jbK47RB7jAE7Tf18mM9JUXXE_OBwJPoTOKCmpqNiXGWwsKZFlXYJSR2hFiWqKiknxBq0I4bSoCBHH6CTGR0JIJSR7h44p5Y1iSq7QyyWYtI74IqXguiWBxcnjH2CdyRs9bv1mHuEFt-vgp9c8WZecn-I5_ma2gxnxQ4DJRmwmi28z7vrXg4gHH_D9Ms8-JPcMuDUB8D2EZ9dDfI_eDmaM8GG_nqKfV18f2pvi7vv1bXtxV_RcyVTYfrBSSQuMia6rOFcD60nNBBgqgdeVFF1GmloAyZlVgySiaYRQBqwcJD9Fn3feOfinBWLSGxd7GEczgV-ilqRpJCcsg5_-Ax_9EvLzomas4YwrITJU7qA--BgDDHoObmPCH02J3hait4XkIHWtcyH5wse9dek2YA_4voGDce1-rX-7AFvD7vPjP-PB-BevlJmS</recordid><startdate>20010601</startdate><enddate>20010601</enddate><creator>Feudtner, Chris</creator><creator>Hays, Ross M</creator><creator>Haynes, Gerri</creator><creator>Geyer, J. Russell</creator><creator>Neff, John M</creator><creator>Koepsell, Thomas D</creator><general>Am Acad Pediatrics</general><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20010601</creationdate><title>Deaths Attributed to Pediatric Complex Chronic Conditions: National Trends and Implications for Supportive Care Services</title><author>Feudtner, Chris ; Hays, Ross M ; Haynes, Gerri ; Geyer, J. 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Russell</creatorcontrib><creatorcontrib>Neff, John M</creatorcontrib><creatorcontrib>Koepsell, Thomas D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feudtner, Chris</au><au>Hays, Ross M</au><au>Haynes, Gerri</au><au>Geyer, J. Russell</au><au>Neff, John M</au><au>Koepsell, Thomas D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deaths Attributed to Pediatric Complex Chronic Conditions: National Trends and Implications for Supportive Care Services</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2001-06-01</date><risdate>2001</risdate><volume>107</volume><issue>6</issue><spage>e99</spage><epage>e99</epage><pages>e99-e99</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Children with complex chronic conditions (CCCs) might benefit from pediatric supportive care services, such as home nursing, palliative care, or hospice, especially those children whose conditions are severe enough to cause death. We do not know, however, the extent of this population or how it is changing over time.
To identify trends over the past 2 decades in the pattern of deaths attributable to pediatric CCCs, examining counts and rates of CCC-attributed deaths by cause and age (infancy: <1 year old, childhood: 1-9 years old, adolescence or young adulthood: 10-24 years old) at the time of death, and to determine the average number of children living within the last 6 months of their lives.
We conducted a retrospective cohort study using national death certificate data and census estimates from the National Center for Health Statistics. Participants included all people 0 to 24 years old in the United States from 1979 to 1997. CCCs comprised a broad array of International Classification of Diseases, Ninth Revision codes for cardiac, malignancy, neuromuscular, respiratory, renal, gastrointestinal, immunodeficiency, metabolic, genetic, and other congenital anomalies. Trends of counts and rates were tested using negative binomial regression.
Of the 1.75 million deaths that occurred in 0- to 24-year-olds from 1979 to 1997, 5% were attributed to cancer CCCs, 16% to noncancer CCCs, 43% to injuries, and 37% to all other causes of death. Overall, both counts and rates of CCC-attributed deaths have trended downward, with declines more pronounced and statistically significant for noncancer CCCs among infants and children, and for cancer CCCs among children, adolescents, and young adults. In 1997, deaths attributed to all CCCs accounted for 7242 infant deaths, 2835 childhood deaths, and 5109 adolescent deaths. Again, in 1997, the average numbers of children alive who would die because of a CCC within the ensuing 6-month period were 1097 infants, 1414 children, and 2548 adolescents or young adults.
Population-based planning of pediatric supportive care services should use measures that best inform our need to provide care for time-limited events (perideath or bereavement care) versus care for ongoing needs (home nursing or hospice). Pediatric supportive care services will need to serve patients with a broad range of CCCs from infancy into adulthood.</abstract><cop>United States</cop><pub>Am Acad Pediatrics</pub><pmid>11389297</pmid><doi>10.1542/peds.107.6.e99</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Cause of Death Child Chronic Disease - epidemiology Chronic Disease - mortality Female Humans Male Mortality - trends Pediatrics Pediatrics - statistics & numerical data United States - epidemiology |
| title | Deaths Attributed to Pediatric Complex Chronic Conditions: National Trends and Implications for Supportive Care Services |
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