Epidemiology of critically ill children in England and Wales: incidence, mortality, deprivation and ethnicity
- Gareth J Parry, Dr (gareth.j.parry{at}gmail.com)
- Sam Jones (s.jones{at}sheffield.ac.uk)
- Krishnan Thiru (thiruk1{at}gosh.nhs.uk)
Abstract
Objective: The purpose of this work was to investigate the incidence rate for admission and mortality of children receiving paediatric intensive care in relation to socioeconomic status and ethnicity in England & Wales.
Design: National cohort of sequential hospital admissions.
Setting: Twenty-nine paediatric intensive care units in England and Wales. Participants All children aged under 16 years admitted to paediatric intensive care in the four years 2004-2007.
Main outcome measures: Incidence rates for admission and odds ratios (OR) for risk adjusted mortality by an area based measure of deprivation (Townsend score) and ethnic group (south Asian versus non-south Asian determined using 2 name analysis algorithms).
Results: Incidence for south Asian children was higher than that of non-south Asians (138 versus 95/100000, incidence rate ratio 1.36, 95% CI 1.32-1.40). The age-sex standardised incidence for children admitted to paediatric intensive care ranged from 69/100000 in the least deprived fifth of the population to 124/100000 in the most deprived fifth. The risk-adjusted OR for mortality for south Asian children was 1.36 (95% CI 1.18-1.57) overall, rising to 2.40 (95% CI 1.40-4.10) in the least deprived fifth of the population when a statistical interaction term for deprivation was included.
Conclusions: In England and Wales, the admission rate to paediatric intensive care is higher in children from more deprived areas and 36% higher for children from the south Asian population. Risked-adjusted mortality increases in south Asian children as deprivation decreases.
