ABSTRACT
INTRODUCCIÓN: En Argentina, la mortalidad por enfermedades malignas en edad pediátrica ocupa un lugar relevante y sus causas todavía no han sido estudiadas en el país. OBJETIVO: Analizar las tasas, causas y etapas de los fallecimientos relacionados con neoplasias en centros públicos seleccionados, desde enero de 2000 a diciembre de 2010. MÉTODOS: Se analizaron las historias clínicas de los pacientes fallecidos por cáncer en centros registrados en el Registro Oncopediátrico Hospitalario Argentino (ROHA) y en los registros individuales de los servicios de Hemato-Oncología. Se clasificaron las causas de mortalidad, la etapa en la cual se produjo el óbito y su relación con el tratamiento o con la patología de base. Se pesquisaron las causas de comorbilidad y las demoras en el diagnóstico y tratamiento. RESULTADOS: En 13 centros se analizó exitosamente un promedio >70...
INTRODUCTION: In Argentina, the mortality of pediatric malignant diseases occupies an important place causes have not yet been studied in the country. OBJECTIVE:To analyze mortality rates, causes and moment of death related to neoplasias in selected public centers from January 2000 until December 2010. METHODS: The analysis was conducted in clinical records of patients who died due to cancer. The cases were registered in the Argentine Hospital Oncopediatric Registry (ROHA)and by different registries belonging to hemato-oncological departments. Mortality causes were classified according to the phase of therapy when the event occurred and the relation shipof death with the treatment or underlying disease. Causes of comorbility and delays in diagnosis/treatment were also analyzed. RESULTS: In 13 centers, more than 70...
Subject(s)
Adolescent , Child, Preschool , Child , Cross-Sectional Studies , Infant Mortality , Hematologic Neoplasms/mortality , Hematologic Neoplasms/pathology , Hematologic Neoplasms/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Statistical Databases , Mortality/statistics & numerical dataABSTRACT
INTRODUCCION: En Argentina, la mortalidad por enfermedades malignas en edad pediátrica ocupa un lugar relevante y sus causas todavía no han sido estudiadas en el país. OBJETIVO: Analizar las tasas, causas y etapas de los fallecimientos relacionados con neoplasias en centros públicos seleccionados, desde enero de 2000 a diciembre de 2010. METODOS: Se analizaron las historias clínicas de los pacientes fallecidos por cáncer en centros registrados en el Registro Oncopediátrico Hospitalario Argentino (ROHA) y en los registros individuales de los servicios de Hemato-Oncología. Se clasificaron las causas de mortalidad, la etapa en la cual se produjo el óbito y su relación con el tratamiento o con la patología de base. Se pesquisaron las causas de comorbilidad y las demoras en el diagnóstico y tratamiento. RESULTADOS: En 13 centros se analizó exitosamente un promedio >70...(AU)
INTRODUCTION: In Argentina, the mortality of pediatric malignant diseases occupies an important place causes have not yet been studied in the country. OBJECTIVE:To analyze mortality rates, causes and moment of death related to neoplasias in selected public centers from January 2000 until December 2010. METHODS: The analysis was conducted in clinical records of patients who died due to cancer. The cases were registered in the Argentine Hospital Oncopediatric Registry (ROHA)and by different registries belonging to hemato-oncological departments. Mortality causes were classified according to the phase of therapy when the event occurred and the relation shipof death with the treatment or underlying disease. Causes of comorbility and delays in diagnosis/treatment were also analyzed. RESULTS: In 13 centers, more than 70...(AU)
Subject(s)
Adolescent , Child, Preschool , Child , Mortality/statistics & numerical data , Infant Mortality , Hematologic Neoplasms/mortality , Hematologic Neoplasms/pathology , Hematologic Neoplasms/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cross-Sectional Studies , Statistical DatabasesABSTRACT
INTRODUCCION: La mortalidad producida de forma temprana y durante diferentes fases del tratamiento de los niños con enfermedades hemato-oncológicas malignan es una de las causas de fracaso de los tratamientos actuales. Las tasas de mortalidad y sus causas no han sido estudiadas en Argentina.OBJETIVO: Analizar las tasas, causas y etapas de los fallecimientos relacionados con neoplasias en 14 centros públicos desde enero de 2000 a diciembre de 2010.METODOS: Se analizaron las historias clínicas de los pacientes fallecidos por cáncer en 14 centros identificados en el Registro Onco-Hematológico Argentino y en los registros individuales de los servicios de Hemato-Oncología. Se clasificaron las causas de muerte, la etapa en la cual se produjo el óbito y su relación con el tratamiento o con la patología de base. Se pesquisaron las causas de co-morbilidad y las demoras en el diagnóstico y tratamiento, así como las particularidades de cada centro.RESULTADOS: En 13 centros se analizó exitosamente un promedio >70% de los óbitos, y en el restante se obtuvieron datos del 35%. La tasa de mortalidad fue >40% en 3 centros, ≥30% en 7 y 30% de mortalidad en los primeros 5 años analizados, la tasa disminuyó a 20% de los pacientes fallecidos. La principal causa de muerte en las etapas tempranas del diagnóstico y tratamiento correspondió a infecciones severas.CONCLUSIONES: Es indispensable desarrollar políticas de salud para revertir la elevada mortalidad en niños con cáncer en Argentina. Para ello, se deben aplicar programas que incluyan reformas estructurales, formación de recursos humanos y equipamiento, además de un trabajo colaborativo continuo y eficiente.
INTRODUCTION:The early mortality occurred at different stages of the treatment agains hemato-oncological malignancies during childhood is one of the causes of failure of modern therapies. In Argentina, the mortality rates and their causes have not been studied yet.OBJECTIVE: To analyze mortality rates, causes and moment of death in children with malignant diseases in 14 public centers from January 2000 until December 2010.METHODS: The analysis was conducted in clinical records of patients who died due to malignant diseases in 14 centers. The cases were identified by the national register for hematology and oncology diseases (ROHA) and by different registers belonging to hemato-oncological departments. Causes were classified according to the phase of therapy when the event occurred and the relationship of death with the treatment or underlying disease. Causes of co-morbility, delays in diagnosis/during treatment and particular features of the centers were also analyzed.RESULTS: In 13 centers, more than 70% of the deaths were successfully analyzed, while there was information of 35% for the remaining one. The mortality rate was >40% in 3 centers, ≥30% in 7 and 30% of mortality during the first 5 years of the analyzed period, the rate decreased to <25% as a hemato-oncologist joined the medical staff. The access to information was difficult in all the centers. In 5 of them there were delays during the diagnostic evaluation and treatment in about 20% of the dead patients. The main cause of death during early phases of diagnosis and treatment was related to severe infectious complications.CONCLUSIONS: It is fundamental to develop appropriate health policies in order to decrease mortality rates among children with cancer in Argentina. They should include programs for structural reform, human resource development and equipment supply, as well as continuous cooperative work.
Subject(s)
Hematologic Diseases , Cancer Care Facilities , Mortality , Infant Mortality , Neoplasms , Argentina , Public HealthABSTRACT
INTRODUCCION: La mortalidad producida de forma temprana y durante diferentes fases del tratamiento de los niños con enfermedades hemato-oncológicas malignan es una de las causas de fracaso de los tratamientos actuales. Las tasas de mortalidad y sus causas no han sido estudiadas en Argentina.OBJETIVO: Analizar las tasas, causas y etapas de los fallecimientos relacionados con neoplasias en 14 centros públicos desde enero de 2000 a diciembre de 2010.METODOS: Se analizaron las historias clínicas de los pacientes fallecidos por cáncer en 14 centros identificados en el Registro Onco-Hematológico Argentino y en los registros individuales de los servicios de Hemato-Oncología. Se clasificaron las causas de muerte, la etapa en la cual se produjo el óbito y su relación con el tratamiento o con la patología de base. Se pesquisaron las causas de co-morbilidad y las demoras en el diagnóstico y tratamiento, así como las particularidades de cada centro.RESULTADOS: En 13 centros se analizó exitosamente un promedio >70% de los óbitos, y en el restante se obtuvieron datos del 35%. La tasa de mortalidad fue >40% en 3 centros, ≥30% en 7 y <25% en 4. En un centro con >30% de mortalidad en los primeros 5 años analizados, la tasa disminuyó a <25% con la incorporación de una hemato-oncóloga. El acceso a los datos fue dificultoso en todos los centros. En 5 de ellos, hubo demoras en el diagnóstico y/o tratamiento en >20% de los pacientes fallecidos. La principal causa de muerte en las etapas tempranas del diagnóstico y tratamiento correspondió a infecciones severas.CONCLUSIONES: Es indispensable desarrollar políticas de salud para revertir la elevada mortalidad en niños con cáncer en Argentina. Para ello, se deben aplicar programas que incluyan reformas estructurales, formación de recursos humanos y equipamiento, además de un trabajo colaborativo continuo y eficiente.
INTRODUCTION:The early mortality occurred at different stages of the treatment agains hemato-oncological malignancies during childhood is one of the causes of failure of modern therapies. In Argentina, the mortality rates and their causes have not been studied yet.OBJECTIVE: To analyze mortality rates, causes and moment of death in children with malignant diseases in 14 public centers from January 2000 until December 2010.METHODS: The analysis was conducted in clinical records of patients who died due to malignant diseases in 14 centers. The cases were identified by the national register for hematology and oncology diseases (ROHA) and by different registers belonging to hemato-oncological departments. Causes were classified according to the phase of therapy when the event occurred and the relationship of death with the treatment or underlying disease. Causes of co-morbility, delays in diagnosis/during treatment and particular features of the centers were also analyzed.RESULTS: In 13 centers, more than 70% of the deaths were successfully analyzed, while there was information of 35% for the remaining one. The mortality rate was >40% in 3 centers, ≥30% in 7 and <25% in 4. At a center which had >30% of mortality during the first 5 years of the analyzed period, the rate decreased to <25% as a hemato-oncologist joined the medical staff. The access to information was difficult in all the centers. In 5 of them there were delays during the diagnostic evaluation and treatment in about 20% of the dead patients. The main cause of death during early phases of diagnosis and treatment was related to severe infectious complications.CONCLUSIONS: It is fundamental to develop appropriate health policies in order to decrease mortality rates among children with cancer in Argentina. They should include programs for structural reform, human resource development and equipment supply, as well as continuous cooperative work.
Subject(s)
Mortality , Hematologic Diseases , Neoplasms , Cancer Care Facilities , Infant Mortality , Argentina , Public HealthABSTRACT
BACKGROUND: While the Northern Hemisphere experiences the effects of the 2009 pandemic influenza A (H1N1) virus, data from the recent influenza season in the Southern Hemisphere can provide important information on the burden of disease in children. METHODS: We conducted a retrospective case series involving children with acute infection of the lower respiratory tract or fever in whom 2009 H1N1 influenza was diagnosed on reverse-transcriptase polymerase-chain-reaction assay and who were admitted to one of six pediatric hospitals serving a catchment area of 1.2 million children. We compared rates of admission and death with those among age-matched children who had been infected with seasonal influenza strains in previous years. RESULTS: Between May and July 2009, a total of 251 children were hospitalized with 2009 H1N1 influenza. Rates of hospitalization were double those for seasonal influenza in 2008. Of the children who were hospitalized, 47 (19%) were admitted to an intensive care unit, 42 (17%) required mechanical ventilation, and 13 (5%) died. The overall rate of death was 1.1 per 100,000 children, as compared with 0.1 per 100,000 children for seasonal influenza in 2007. (No pediatric deaths associated with seasonal influenza were reported in 2008.) Most deaths were caused by refractory hypoxemia in infants under 1 year of age (death rate, 7.6 per 100,000). CONCLUSIONS: Pandemic 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza in previous years.
