Trends in Sickle Cell Disease Mortality: 1979-2020.

IF 6.2 2区医学 Q1 PEDIATRICS

Pediatrics Pub Date : 2024-11-18 DOI:10.1542/peds.2024-067341

Kristine A Karkoska, Patrick T McGann

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引用次数: 0

Abstract

Background and objectives: Although sickle cell disease (SCD)-related childhood mortality in the United States significantly improved in the 1990s, unclear is the trend in SCD-related mortality more recently given the continued disparities faced by this minoritized population. In this analysis, we aimed to (1) compare the overall and age-specific mortality rates from 1999 to 2009 vs 2010 to 2020 with a particular focus on the age of transition and (2) determine the most common causes of death for the US SCD population for 2010 to 2020.

Methods: We analyzed publicly available data from the Centers for Disease Control and Prevention WONDER database, a compilation of national-level mortality statistics from 1979 to 2020 derived from death certificates compiled by the National Center for Health Statistics. We searched by all individuals of all ethnicities, sexes, and ages using the underlying cause of death.

Results: The crude mortality rate for individuals with SCD for 2010 to 2020 was 1.6 per 1 000 000 individuals, which was significantly lower than the period 1999 to 2009 (crude rate 1.7 per 1 000 000, P < .0001). In addition, the mean age at mortality of those with SCD was older in 2010 to 2020 (43 years) versus 1999 to 2009 (39 years). However, there remains a significant increase in mortality rate in the 20 to 24 year age group versus 15 to 19 years (1.7 per 1 000 000 versus 0.7 per 1 000 000, P < .0001), corresponding with the age of transition from pediatric to adult centers. In addition, 39% of underlying causes of death were not caused by SCD, but rather primarily chronic conditions, including cardiovascular, cerebrovascular, malignancy, and renal disease. The study has several limitations mostly because of the imperfections of administrative data sources, including inaccuracies in diagnoses codes, risking over or undercounting.

Conclusions: Although the US SCD-related mortality rate continues to decrease, the age of transition to adult care is a particularly vulnerable time in the lives of this marginalized group. Innovative and expanded approaches to care are greatly needed.

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镰状细胞病死亡率趋势：1979-2020 年。

背景和目标：尽管美国与镰状细胞病（SCD）相关的儿童死亡率在 20 世纪 90 年代有了明显改善，但鉴于这一少数群体面临的持续差异，近期与 SCD 相关的死亡率趋势尚不明确。在这项分析中，我们的目标是：（1）比较 1999 年至 2009 年与 2010 年至 2020 年的总体死亡率和特定年龄死亡率，尤其关注过渡年龄；（2）确定 2010 年至 2020 年美国 SCD 人口最常见的死亡原因：我们分析了美国疾病控制和预防中心 WONDER 数据库中的公开数据，该数据库汇集了从 1979 年到 2020 年的国家级死亡率统计数据，这些数据来自国家卫生统计中心（National Center for Health Statistics）编制的死亡证明。我们使用基本死因对所有种族、性别和年龄的所有个体进行了搜索：2010 年至 2020 年，SCD 患者的粗死亡率为 1.6‰，明显低于 1999 年至 2009 年（粗死亡率为 1.7‰，P < .0001）。此外，2010 年至 2020 年期间，SCD 患者的平均死亡年龄（43 岁）比 1999 年至 2009 年期间（39 岁）要大。然而，20 至 24 岁年龄组的死亡率与 15 至 19 岁年龄组相比仍有显著增加（1.7‰对 0.7‰，P < .0001），这与从儿科中心向成人中心过渡的年龄相符。此外，39%的潜在死因并非由SCD引起，而主要是慢性疾病，包括心血管、脑血管、恶性肿瘤和肾脏疾病。这项研究存在一些局限性，主要是因为行政数据源的不完善，包括诊断代码的不准确，有可能造成多计或少计：尽管美国与 SCD 相关的死亡率持续下降，但在这一边缘群体的生命中，向成人护理过渡的年龄段是特别脆弱的时期。我们亟需创新和扩展护理方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics 医学-小儿科

CiteScore

12.80

自引率

5.00%

发文量

791

审稿时长

2-3 weeks

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