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A Study of Children Dying within 24 Hours After Admission

Journal of the Korean Pediatric Society 1971;14(5):281-290.
Published online May 31, 1971.
A Study of Children Dying within 24 Hours After Admission
Han Ky Hwang
Department of Pediatrics, Yonsei University College of Medicine
입원 24 시간 이내의 사망 환자에 관한 연구
黃 滿 语
연세대학교 의과대학 소아과학교실
Almost every practicing pediatrician has encountered the tragic enigma of children dying within 24 hours after admission, and especially when it is a sudden and unexpected death of a previously healthy infant. This is the clinical report concerning the pediatric deaths within the first 24 hours after admission including sudden and unexpected deaths observed on the pediatric ward of Severance Hospital, Yonsei University during the past 11 years from Oct. 1, 1959 to Sept. 30, 1970. The total number of admitted patients under 15 years of age on the pediatric ward for the same period was 7,709, of whom 62. 3% were male. Among these 238 patients (3.1%) expired within 24 hours after admission. Data were analyzed by annual incidence, sex, age, case fatality rate by diseases, cause of death by age group and seasonal incidence. They were compared also with all admitted patients of the same period. The following results were obtained: 1.Mortality rate by year; Average death rate was 3.1%. 6. 7% in 1959 decreased progressively to 1.3% in 1970. 2.65. 5% of the total of 238 deaths were less than one year of age. 3.There was no significant difference between both sex. 4.Case fase rate by disease showed neonatal tetanus as the cause in 23. 8%, birth injury 15. 6%, septicemia 8. 8%, meningitis 7. 8% and prematurity 7. 8% respectively. 5.Cause of death by age group were as follows; a). In the neonatal period) neonatal tetanus was the most common one (18. 6% of total neonatal deaths) and others were premature (14. 6% and bronchopneumonia (14. 6%). b). In infancy the most common cause of death was bronchopneumonia (34. 4% of total infancy deaths), and others were meningitis and gastroentroenteritis (8. 6%). c) In early childhood from one to four years of age, meningitis was (26. 8% of total early childhood age) encephalitis (17. 3%) and bronchopneumonia (14. 6%) in that order. d) From five to fifteen years of age, meningitis(22.1% of total this age group), encephalitis (12.1%) and bronchopneumonia (7.3%) were the major causes of death. 6.Seasonal incidence of death showed a peak in August, 31 (13. 0%) and summer (June, July and August, 84, 35. 3%). In February there were only 9 cases (3. 8%). 7. 87 patients (36. 5%) had been treated at local clinics before admission. 12 patients (5. 0%) had been treated herb medicine and 11 (4. 6%) had been treated by medicine at home. But a half of the patients had not been treated at all. Thus it can be appreciated that the number of the infant involved is sufficiently great to constitute what might be termed a real public health problem.

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