title: Prevalence of life-threatening conditions in children.
abstract: OBJECTIVE
  We estimated the prevalence of children with life-threatening conditions (LTC) cared for in the military health system (MHS) in response to a Congressional inquiry and to inform program planning.
  
  
  METHODS
  We developed a case definition of LTC, using the concept ''death trajectory''(1,2) to define our cases. We conducted an unduplicated count of children with LTC in the MHS database during FY 2001/FY 2002 using selected ICD-9 codes based on our case definition. We then surveyed the literature for reported prevalence of LTC among children with similar case definitions. The concept of ''death trajectory'' describes non-categorical life-threatening conditions of four types: progressive decline to death (e.g., spinal muscular atrophy); intermittent periods of intensive care to maintain quality-of-life (e.g., cystic fibrosis); curative treatment is possible but may fail (e.g., childhood cancers); and severe but non-progressive disability with extreme health vulnerability (e.g., spastic quadriplegia with tracheotomy).
  
  
  RESULTS
  There were 3,976 children identified with LTC in a population of 2.6 million children, for a prevalence of 0.15%.
  
  
  CONCLUSIONS
  A prevalence of 0.15% for children with LTC in the MHS population agrees closely with that derived for similar case definitions by other authors among populations of children in other single-payer health care systems (i.e., United Kingdom). The method used here may apply to similar health care systems with ICD 9 codes in a searchable database.
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. vrandall@usuhs.mil
authors.forename: Virginia
authors.initials: V
authors.lastname: Randall
authors.forename: Jason
authors.initials: J
authors.lastname: Cervenka
authors.forename: David
authors.initials: D
authors.lastname: Arday
authors.forename: Tomoko
authors.initials: T
authors.lastname: Hooper
authors.forename: Janice
authors.initials: J
authors.lastname: Hanson
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D002908:Chronic Disease / Q000145:classification / Q000453:epidemiology*; D016638:Critical Illness / Q000145:classification / Q000453:epidemiology*; D019988:Children with Disabilities / Q000145:classification / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010166:Palliative Care / Q000458:organization & administration; D015995:Prevalence; D011785:Quality Assurance, Health Care; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology