Changing Trends Of Etiologic Characteristics Of Nervous System Diseases Among Hospitalized Children

Objective1. To investigate the trends in the change of etiologic types of nervous system diseases among hospitalized children from 1993 to 2006 by data of disease constituent ratio, death ratio, characteristics of demography (including sex and age) and provide dependencies for clinical practice and formulation of hygienical strategies.2. To analyze the risk factors of death cases in hospitalized children with nervous system diseases and provide reference data to control and decrease the death rate of nervous system diseases.Methods1. The time interval from 1993 to 2006 was cut into two groups: from 1993 to 1999 and from 2000 to 2006.2. This investigation was implemented by case organizing systemic software. All nervous system diseases being the main diagnosis of hospitalized children aged from 0 to 18 years old were selected. The investigation content included the characteristics of demography (including sex and age), discharging date, hospitalization days, discharging diagnosis and prognosis.3. The retrospective estimate was based on the data survey in all patients meeting the inclusion criteria. All data was analyzed by SPSS12.0 software. Diagnoses were categorized using the International Classification of diseases, 10th Revision.Results1. A total of 8619 hospitalized children with different etiologic types of nervous system diseases from 1993 to 2006 were reviewed. The percentage of nervous system diseases among the inpatients in all wards was significantly increased during this period, being 2.37% and 3.56% (P<0.001).2. Patterns of different etiologic types of nervous system diseases changed steadily from 1993 to 2006. Epilepsies and seizures took the first place in both year group (from 1993 to 1999 and from 2000 to 2006), being 29.44% and 35.00%. The first ten patterns of different etiologic types of nervous system diseases were the same, being epilepsies and seizures, infections of central nervous system, auto-immune and demyelinated disorders, cerebral palsy, motor unit disorders, hypoxic ischemic encephalopathy, hydrocephalus, extra-pyramidal disorders, congenital abnormalities of nervous system, headache. The percentage of epilepsies and seizures, hypoxic ischemic encephalopathy, hydrocephalus, extra-pyramidal disorders, congenital abnormalities of nervous system, headache among the inpatients in all nervous system diseases was significantly increased during this period(P<0.05). The percentage of infections of central nervous system, auto-immune and demyelinated disorders, cerebral palsy, motor unit disorders among the inpatients in all nervous system diseases was significantly decreased during this period (P<0.05).3. The death number altogether from 1993 to 2006 was 34, being 24 and 10 cases respectively in the year group, which seemed no significant change. The death rate of the year group was significantly decreased, being 0.95% and 0.16% (P<0.05). The death number from infections of central nervous system was the most in both year groups, which seemed no significant change. The death number from other encephalopathy was significantly increased during the period (P<0.05).4. From 1993 to 2006 the youngest is 0.1 years and the oldest is 18.0 years old. The percentage of age younger than 3 years, 5 years and 11 years was 51.78%, 63.82% and 91.09%. Patients were significantly older from 2000 to 2006(4.15±4.15) years than those from 1993 to 1999(4.14±3.91)years (P<0.05).5. The average hospitalization days were significantly shorter from 2000 to 2006(8.18±10.76) days than those from 1993 to 1999(9.88±9.57)days(P<0.05).6. A further logistic regression analysis showed the independent risk factors of death in nervous system diseases were hospitalization days, year group, infection of central nervous system, cerebrovascular diseases and other encephalopathy.Conclusions1. Hospitalization patterns of nervous system diseases have changed steadily since 2000. The percentage of epilepsies and seizures, hypoxic ischemic encephalopathy, hydrocephalus, extra-pyramidal disorders, congenital abnormalities of nervous system, headache among the inpatients in all nervous system diseases was significantly increased, which we should pay more attentions in future clinical practice.2. Infection of central nervous system was still the main cause of death in hospitalized children with nervous system diseases. The raise of pathogenic positive rate and the identification of etiology was the key to effective diagnosis and treatment.3. The death risk of nervous system diseases could be predicted by hospitalization days, year group, infection of central nervous system, cerebrovascular diseases and other encephalopathy by one way analysis and logistic regression. These risk factors should be analyzed altogether to control and decrease the death rate of nervous system diseases, which was a main task for neurological pediatrician in the future.4. How to effectively improve correct diagnosis of nervous system diseases and how to decrease the death rate by effective managements will be a direction for neurological pediatrician to word hard.