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Potentially preventable infant and child deaths identified at autopsy; findings and implications

Bamber, A; Pryce, J; Mifsud, W; Wolfe, I; Cass, H; Malone, M; Sebire, NJ; (2015) Potentially preventable infant and child deaths identified at autopsy; findings and implications. Forensic Science Medicine and Pathology , 11 (3) pp. 358-364. 10.1007/s12024-015-9681-9. Green open access

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Abstract

Purpose The purpose of the study was to determine the proportion of pediatric deaths investigated by HM Coronial autopsy which were potentially preventable deaths due to treatable natural disease, and what implications such findings may have for health policies to reduce their occurrence. Methods A retrospective study of 1779 autopsies of individuals between 7 days and 14 years of age requested by HM Coroner, taking place in one specialist pediatric autopsy center, was undertaken. Cases were included if they involved a definite natural disease process in which appropriate recognition and treatment was likely to have affected their outcome. Strict criteria were used and cases were excluded where the individual had any longstanding condition which might have predisposed them to, or altered the recognition of, acute illness, or its response to therapy. Results Almost 8 % (134/1779) of the study group were potentially preventable deaths as a result of natural disease, the majority occurring in children younger than 2 years of age. Most individuals reported between 1 and 7 days of symptoms before their death, and the majority had sought medical advice during this period, including from general practitioners within working hours, and hospital emergency departments. Of those who had sought medical attention, around one-third had done so more than once (28 %, 15/53). Sepsis and pneumonia accounted for the majority of deaths (46 and 34 % respectively), with all infections (sepsis, pneumonia and meningitis) accounting for 110/134 (82 %). Conclusion Around 10 % of pediatric deaths referred to HM Coroner are potentially preventable, being the result of treatable natural acute illnesses. In many cases medical advice had been sought during the final illness. The results highlight how a review of autopsy data can identify significant findings with the potential to reduce mortality, and the importance of centralized investigation and reporting of pediatric deaths.

Type: Article
Title: Potentially preventable infant and child deaths identified at autopsy; findings and implications
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s12024-015-9681-9
Publisher version: http://dx.doi.org/10.1007/s12024-015-9681-9
Additional information: Copyright © Springer Science+Business Media New York 2015. The final publication is available at Springer via http://dx.doi.org/10.1007/s12024-015-9681-9.
Keywords: Autopsy, Preventable, Death, Infant, Child.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1469158
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