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Multiple Causes of Death Associated with Pediatric Cardiopulmonary Arrest from 1996 to 2019 in Brazil
Thayanne Mendes de Andrade1, Mariara Lopes da Costa Marques1, Thaís Rocha Salim1,2
1Programa de Pós-graduação em Cardiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil.
Insights
Cardiopulmonary arrest (CPA) was recorded in 11.6% of deaths in individuals under 20 in Brazil. Respiratory, hematologic, and neoplastic diseases were primary causes when CPA occurred, highlighting the need for improved pediatric resuscitation strategies.
Area of Science:
- Pediatric mortality analysis
- Public health research
- Epidemiology of cardiopulmonary arrest
Background:
- Cardiopulmonary arrest (CPA) in pediatrics leads to high mortality and severe neurological outcomes.
- Understanding causes of death in individuals under 20 is crucial for improving child and adolescent health.
- Data on CPA frequency and causes in young populations can inform targeted interventions.
Purpose of the Study:
- To analyze mortality rates and causes in Brazilian individuals under 20 from 1996-2019.
- To determine the incidence of cardiopulmonary arrest (CPA) on death certificates (DCs).
- To identify locations of death and inform strategies for mortality prevention.
Main Methods:
- Ecological time-series study analyzing deaths in individuals under 20 (1996-2019) in Brazil.
- Evaluation of mortality rates (MRs) and proportional mortality (PM) by primary cause of death.
- Analysis of CPA presence on death certificates and death locations using DATASUS, IBGE, and SINASC data.
Main Results:
- Over 2.1 million deaths occurred in individuals under 20, with a mortality rate of 134.38/100,000.
- Cardiopulmonary arrest (CPA) was noted on 11.6% of death certificates.
- Highest CPA rates were in neonates (22%) and 1-4 year olds (26%), with respiratory, hematologic, and neoplastic diseases as primary causes.
Conclusions:
- Perinatal and external causes were leading causes of death under 20 in Brazil.
- Respiratory, hematologic, and neoplastic diseases were associated with CPA when considering multiple causes.
- Most deaths occurred in hospitals, indicating a need for better understanding of event sequences and improved pediatric resuscitation training.
Background:
In pediatrics, cardiopulmonary arrest (CPA) is associated with high mortality and severe neurologic sequelae. Information on the causes and mechanisms of death below the age of 20 years could provide theoretical support for health improvement among children and adolescents.
Objectives:
To conduct a population analysis of mortality rates due to primary and multiple causes of death below the age of 20 years in both sexes from 1996 to 2019 in Brazil, and identify the frequency in which CPA was recorded in the death certificates (DCs) of these individuals and the locations where the deaths occurred, in order to promote strategies to improve the prevention of deaths.
Method:
Ecological time-series study of deaths below the age of 20 years from 1996 to 2019, evaluating the mortality rates (MRs) and proportional mortality (PM) by primary cause of death. We analyzed the percentages of CPA recorded in any line of the DC and the location where the deaths occurred. We calculated the MRs per 100,000 inhabitants and the PM by primary cause of death under the age of 20 years according to sex and age group, the percentages of death from primary causes by age group when CPA was described in any line of Parts I and II of the DC, and the percentage of deaths from primary causes according to their location of occurrence. We retrieved the data from DATASUS, IBGE, and SINASC.
Results:
From 1996 to 2019, there were 2,151,716 deaths below the age of 20 years in Brazil, yielding a mortality rate of 134.38 per 100,000 inhabitants. The death rate was highest among male neonates. Of all deaths, 249,334 (11.6%) had CPA recorded in any line of the DC. Specifically, CPA was recorded in 49,178 DCs between the ages of 1 and 4 years and in 88,116 of those between the ages of 29 and 365 days, corresponding, respectively, to 26% and 22% of the deaths in these age groups. These two age groups had the highest rates of CPA recorded in any line of the DC. The main primary causes of death when CPA was recorded in the sequence of death were respiratory, hematologic, and neoplastic diseases.
Conclusion:
Perinatal and external causes were the primary causes of death, with highest MRs under the age of 20 years in Brazil from 1996 to 2019. When multiple causes of death were considered, the main primary causes associated with CPA were respiratory, hematologic, and neoplastic diseases. Most deaths occurred in the hospital environment. Better understanding of the sequence of events in these deaths and improvements in teaching strategies in pediatric cardiopulmonary resuscitation are needed.
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