Causes of death, determined by autopsy, in previously healthy (or near-healthy) children presenting to a children's hospital.
BACKGROUND
Childhood mortality statistics are based on death certificates. The causes of death listed on death certificates may not be confirmed by autopsy findings, and mortality statistics may reflect deaths of many children with chronic disease. The diseases responsible for nontraumatic deaths of previously healthy children cannot be determined from these statistics.


OBJECTIVE
To identify causes of nontraumatic death in previously healthy or near-healthy children presenting to a children's hospital.


METHODS
Retrospective review of autopsy protocols from 572 children who died at Children's Hospital of New Orleans in Louisiana between 1985 and 2003, with the premise that autopsy was done after most deaths of previously healthy or near-healthy children. Causes of death were grouped by disease processes and age groups and were compared to premortem clinical diagnoses.


RESULTS
Eighty-eight autopsy protocols were from children who were previously healthy or near healthy before the hospital admission during which they died. The median age was 11.4 months and the median length of stay was 2 days. Infection, primarily of the central nervous system and systemic (septicemia), was the most common cause of death (53%, 47 cases). Neoplasia, primarily of the central nervous and hematologic systems, was the second most common cause (15%, 13 cases). The predominant organ system involved with disease was the nervous system (36%, 32 cases). Unrecognized congenital disorders were found in approximately 10% of the cases.


CONCLUSIONS
Infectious diseases are a frequent cause of death in previously healthy children. Fatal diseases most frequently affect the nervous system. Autopsy provides valuable information in the death of healthy children.
Taggart
Melissa W
MW
Louisiana State University Health Sciences Center, New Orleans, USA.
Craver
Randall
R
D000293:Adolescent; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000401:mortality; D003644:Death Certificates; D003645:Death, Sudden / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D017052:Hospital Mortality; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008145:Louisiana / Q000453:epidemiology; D008297:Male