The Predictors of Hospital-Death Among Children in Western Iran
Analyzing child mortality, an important indicator of health and development of countries, can help policymakers to develop health programs that resulted in improving Childs’s health. Recognizing the causes of in-hospital deaths also assists health caregivers to revise their medical services. The aim of this study was to explore the causes of death in the largest hospital in western Iran. This retrospective descriptive-analytical study was conducted in Imam Reza Hospital (IRH) in Kermanshah, data including demographic characteristics (e.g., age), medical information, and causes of death of patients aged ≤18 years, from April 2012 to March 2017 were collected using a checklist. The causes of mortalities were categorized based on the International Coding of Diseases (ICD, Version 10). Using logistic regression, Chi-square, and Cramer's V test in SPSS, the relationships between the outcome and predicting variables were assessed. The results showed 1113 deaths among 21,247 people≤, 18 years people admitted to IRH for five years. About 55% were female and 74% neonate, with a dropping trend from 2011 (4.62%) to 2016 (4.00%). Medical records, mostly, used a variety of usual medical terms for the causes of death, rather than using ICD10 categories. Data were analyzed after alternating medical terms and re-coding data using ICD10. Respiratory system diseases by 34% (dominancy of hyaline membrane diseases), infectious diseases by 28% (leading by sepsis), and diseases of the blood by 13% (mostly disseminated intravascular coagulation (DIC)), respectively, were the most common causes of death. Age was the most important associated factor for all-cause mortality associated with infectious diseases and respiratory system diseases (P=0.01). Having a significant number of neonatal mortality, paying more attention to the neonatal, prenatal, and antenatal care is recommended. In addition, the fatality of infectious diseases is concerning and needs paying serious attention to the health care system.
2. Group DBRCoCHDW. Starting early: a life-course perspective on child health disparities—research recommendations. Pediatrics 2009;124:S257-61.
3. Wang H, Bhutta ZA, Coates MM, Coggeshall M, Dandona L, Diallo K, et al. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016;388:1725-74.
4. Bryce J, Black RE, Victora CG. Millennium Development Goals 4 and 5: progress and challenges. BMC Med 2013;11:225.
5. Ki-Moon B. The Millennium Development Goals Report 2013. United Nations Pubns, 2013.
6. You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, et al. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet 2015;386:2275-86.
7. Tajedini F, Ehdaievand F, Farsar A. Epidemiological features of children mortality in the area covered by Shahid Beheshti university of medical sciences in 2012. J Clin Nurs Midwifery 2014;4:62-71.
8. Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? lancet 2003;361:2226-34.
9. WHO. World health statistics 2015: World Health Organization; 2015.
10. WHO. Death reviews: maternal, perinatal and child. WHO; 2013.
11. Vaid A, Mammen A, Primrose B, Kang G. Infant mortality in an urban slum. Indian J Pediatr 2007;74:449-53.
12. Barak M, Sadeghieh Ahari S, Amani F, Asadi G, Rahimi G, Khadem E. Causatives and Risk Factors for Deaths among Infants Under 1 Year Old in Ardabil Slums during 2008-2009. J Ardabil Univ Med Sci 2012;12:40-7.
13. Rabbani S, Qayyum A. Comparative analysis of factor affecting child mortality in Pakistan. Res J Soc Sci 2017;4,1-17.
14. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379:2151-61.
15. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet 2015;385:430-40.
16. Namakin K, Sharifzadeh G. The evaluation of infants mortality causes and its related factors in Birjand. J Isfahan Med Sch 2009;27:275-82.
17. Sawyer CC. Child mortality estimation: estimating sex differences in childhood mortality since the 1970s. PLoS Med 2012;9:e1001287.
18. Dongying Z, Lile Z, Xiaoping L, Yongjun Z. Gender Differences in Infant Mortality and Neonatal Morbidity in Mixed-Gender Twins. Sci Rep 2017;7:8736.
19. Patel KK, Gouda J. Infant Mortality in Northern and Southern Regions of India: Differentials and Determinants. Soc Sci Spectr 2018;3:81-92.
20. Sahu D, Nair S, Singh L, Gulati B, Pandey A. Levels, trends & predictors of infant & child mortality among Scheduled Tribes in rural India. Indian J Med Res 2015;141:709-19.
21. Izadi N, Shetabi H, Bakhtiari S, Janat AM, Parabi M, Ahmadi K. The Rate and Causes of Infant Mortaliry in the Hospitals of Kermanshah Province During 2011-2014. J Rafsanjan Univ Med Sci 2016,15:129-38.
22. Xu YH, Huang XW, Yang RL. The under-five mortality rate and the causes of death in Zhejiang Province between 2000 and 2009. Zhongguo Dang Dai Er Ke Za Zhi 2011;13:561-4.
23. Ntuli ST, Malangu N, Alberts M. Causes of deaths in children under-five years old at a tertiary hospital in Limpopo province of South Africa. Glob J Health Sci 2013;5:95-100.
24. Sankaran K, Chien LY, Walker R, Seshia M, Ohlsson A, Lee SK. Variations in mortality rates among Canadian neonatal intensive care units. CMAJ 2002;166:173-8.
25. Lawn JE, Wilczynska-Ketende K, Cousens SN. Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epidemiol 2006;35:706-18.
26. Hamilton BE, Hoyert DL, Martin JA, Strobino DM, Guyer B. Annual summary of vital statistics: 2010–2011. Pediatrics 2013:131:548-58.
27. Hemmati M, Gheini S. Neonatal mortality rate prevalence in Motazedi hospital of Kermanshah (2002-2003). J Kermanshah Univ Med Sci. 2006;10:e81721.
28. Nayeri F, Amini E, Yazdi ZO, Naieri AD. Evaluation of the cause and predisposing factors in neonatal mortality by using international coding diseases version 10 in Valiasr Hospital. Iran J Pediatr 2007;17:21-6.
29. Alijani Ranani H, Madhoshi S, Moghimzadeh F. Evaluation of the cause and predisposing factors in neonatal mortality based on international coding disease version10 in Aboozar Hospital of Ahvaz. Yafte 2017;19:124-33.
30. Patel RM, Kandefer S, Walsh MC, Bell EF, Carlo WA, Laptook AR, et al. Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med 2015;372:331-40.
31. Mokdad AH, Forouzanfar MH, Daoud F, Mokdad AA, El Bcheraoui C, Moradi-Lakeh M, et al. Global burden of diseases, injuries, and risk factors for young people's health during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2016;387:2383-401.
|Issue||Vol 58, No 11 (2020)|
|Children Infants Death Iran Mortality|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|