Etiology Analysis Of Death Cases Due To Respiratory Diseases In Shenzhen Children’s Hospital From 2013 To 2018

Objective: This paper analyzes the characteristics of the clinical data of the deaths from respiratory diseases of hospitalized children in shenzhen children’s hospital,so as to provide reference for formulating the corresponding preventive measures,improving the level of diagnosis and treatment,and reducing the fatality rate of children’s respiratory diseases.Methods: Clinical data of hospitalized patients with respiratory diseases who died in shenzhen children’s hospital from January 2013 to December 2018 were collected,including age,gender,onset season,death diagnosis,basic diseases,and pathogen infection,etc.,and analyzed retrospectively.Results:1.General information: From January 2013 to December 2018,165 patients died of respiratory diseases in Shenzhen Children’s Hospital,accounting for 22.54% of the total,ranking second in the list.There were 101 males(61.21%)and 64 females(38.79%),with a male-to-female ratio of 1.58:1.The proportion of neonatal deaths was the highest(107/165,64.85%),followed by infants(35/165,21.21%)and the proportion of school-age deaths was the lowest(2/165,1.21%).2.The cause of death of respiratory diseases in the neonatal period is different from that outside the neonatal period.The top 3 causes of neonatal respiratory deaths were neonatal acute respiratory distress syndrome(45/107,42.06%),neonatal asphyxia(36/107,33.64%)and neonatal meconium inhalation syndrome(11/107,10.28%).The top 3 causes of respiratory deaths outside the neonatal period were pneumonia(50/58,86.21%),bronchopulmonary dysplasia(4/58,6.90%),and tracheal stenosis(3/58,5.17%).3.The mortality rate of neonatal acute respiratory distress syndrome between January2013 and December 2018 showed a decreasing trend,and the difference was statistically significant by the linear trend 2 test(2 = 10.971,P =0.001).There was no significantdifference in the mortality of neonatal pneumonia between January 2013 and December2018(2 = 6.519,P=0.259).4.Pneumonia was the leading cause of death in the neonatal respiratory system,with a total of 50 cases(50/58,86.21%),including 33 males(33/50,66.66%)and 17 females(17/50,34.44%).The ratio of male to female was 1.94:1.The death composition ratio was the highest in infants(29/50,58.00%)and the lowest in school-age children(2/50,4.00%).There was no statistically significant difference in pneumonia fatality rate between different age groups(2 = 0.601,P=0.438).Winter and spring deaths accounted for 66.00%(33/50);Children with underlying diseases accounted for 54.00%(27/50),of which malnutrition(20/27,74.07%)was the most common.Among the 50 children who died of pneumonia,31(31/50,62.00%)had positive pathogen test,and the bacteria were mainly pseudomonas aeruginosa and streptococcus pneumoniae.The virus is mainly influenza virus.The drug sensitivity results showed that the main pathogenic bacteria had a high drug resistance rate to penicillin and cephalosporin antibiotics,the main gram-negative bacteria had a high sensitivity rate to carbapenems antibiotics,and the main gram-positive bacteria had a high sensitivity rate to vancomycin and linezolid.Conclusion:1.The causes of death of respiratory diseases during the neonatal period are different from those outside the neonatal period.Acute respiratory distress syndrome(ARDS)was the main cause of respiratory death in neonatal period,while pneumonia was the main cause of respiratory death in neonatal period.2.Neonatal pneumonia deaths were more common in infants,winter and spring,combined with basic diseases and special pathogen infections,among which pseudomonas aeruginosa and Streptococcus pneumoniae were the main bacteria,influenza virus was the main virus,and mycoplasma pneumoniae was the main atypical pathogen.