Faculty Opinions recommendation of How many children and young people with life-limiting conditions are clinically unstable? A national data linkage study.

Aims and methodTo review the deaths of children and young people who took their own life. We conducted a retrospective analysis of serious incident reports from a National Health Service trust and reviews by the child death overview panels of the local safeguarding children boards.ResultsWe identified 23 deaths, with annual rates varying considerably between local authorities and over time. Over half of the children (n = 13, 56%) were not known to specialist child and adolescent mental health services, with 11 having no contact with any agency at the time of their death. Hanging was the most common method (n = 20, 87%) and of these, half (n =11, 55%) were low-level hangings.Clinical implicationsTraining is required to improve awareness, recognition and the assessment of children at risk of taking their own life. Specialist child mental health services should directly assess plans or attempts at hanging and offer advice about the seriousness of attempting this. National data (by age) on children and young people who take their own life should be routinely published to inform clinical and preventive services.

Download Full-text

Length of Acute Coronary Syndrome Hospitalisation in New Zealand 2006–2016: An All New Zealand Acute Coronary Syndrome-Quality Improvement National Data Linkage Study of Patterns and Predictors

Heart Lung and Circulation ◽

10.1016/j.hlc.2019.05.045 ◽

2019 ◽

Vol 28 ◽

pp. S17

Author(s):

Tom Kai Ming Wang ◽

Corina Grey ◽

Yannan Jiang ◽

Rod Jackson ◽

Andrew Kerr

Keyword(s):

Acute Coronary Syndrome ◽

Quality Improvement ◽

New Zealand ◽

Data Linkage ◽

Linkage Study ◽

National Data ◽

Coronary Syndrome

Download Full-text

How many children and young people with life-limiting conditions are clinically unstable? A national data linkage study

Archives of Disease in Childhood ◽

10.1136/archdischild-2016-310800 ◽

2016 ◽

Vol 102 (2) ◽

pp. 131-138 ◽

Cited By ~ 12

Author(s):

Stuart Jarvis ◽

Roger C Parslow ◽

Pat Carragher ◽

Bryony Beresford ◽

Lorna K Fraser

Keyword(s):

Young People ◽

South Asian ◽

Lower Risk ◽

Clinical Stage ◽

Age Groups ◽

Linkage Study ◽

Children And Young People ◽

Healthcare Data ◽

Paediatric Palliative Care ◽

National Cohort

ObjectiveTo determine the clinical stage (stable, unstable, deteriorating or dying) for children and young people (CYP) aged 0–25 years in Scotland with life-limiting conditions (LLCs).DesignNational cohort of CYP with LLCs using linked routinely collected healthcare data.SettingScotland.Patients20 436 CYP identified as having LLCs and resident in Scotland between 1 April 2009 and 31 March 2014.Main outcomeClinical stage based on emergency inpatient and intensive care unit admissions and date of death.ResultsOver 2200 CYP with LLCs in Scotland were unstable, deteriorating or dying in each year. Compared with 1-year-olds to 5-year-olds, children under 1 year of age had the highest risk of instability (OR 6.4, 95% CI 5.7 to 7.1); all older age groups had lower risk. Girls were more likely to be unstable than boys (OR 1.15, 95% CI 1.06 to 1.24). CYP of South Asian (OR 1.61, 95% CI 1.28 to 2.01), Black (OR 1.58, 95% CI 1.04 to 2.41) and Other (OR 1.33, 95% CI 1.02 to 1.74) ethnicity were more likely to experience instability than White CYP. Deprivation was not a significant predictor of instability. Compared with congenital abnormalities, CYP with most other primary diagnoses had a higher risk of instability; only CYP with a primary perinatal diagnosis had significantly lower risk (OR 0.23, 95% CI 0.19 to 0.29).ConclusionsThe large number of CYP with LLCs who are unstable, deteriorating or dying may benefit from input from specialist paediatric palliative care. The age group under 1 and CYP of South Asian, Black and Other ethnicities should be priority groups.

Download Full-text