Variations in Cause-of-Death Determination for Sudden Unexpected Infant Deaths
| Autor: | Sharyn E. Parks, Betsy Payn, Tom Andrew, Carrie K. Shapiro-Mendoza, Lena Camperlengo, Dale A. Rhoda, Jennifer Brustrom, John Fudenberg |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Cross-sectional study Poison control Death Certificates Article Occupational safety and health Young Adult 03 medical and health sciences 0302 clinical medicine Cause of Death 030225 pediatrics Injury prevention Humans Medicine Medical history 030216 legal & forensic medicine Aged Cause of death business.industry Infant Newborn Infant Middle Aged Sudden infant death syndrome medicine.disease United States Infant mortality Cross-Sectional Studies Pediatrics Perinatology and Child Health Emergency medicine Female Medical emergency business Coroners and Medical Examiners Sudden Infant Death |
| Zdroj: | Pediatrics. 140 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2017-0087 |
| Popis: | OBJECTIVES: To quantify and describe variation in cause-of-death certification of sudden unexpected infant deaths (SUIDs) among US medical examiners and coroners. METHODS: From January to November 2014, we conducted a nationally representative survey of US medical examiners and coroners who certify infant deaths. Two-stage unequal probability sampling with replacement was used. Medical examiners and coroners were asked to classify SUIDs based on hypothetical scenarios and to describe the evidence considered and investigative procedures used for cause-of-death determination. Frequencies and weighted percentages were calculated. RESULTS: Of the 801 surveys mailed, 60% were returned, and 377 were deemed eligible and complete. Medical examiners and coroners classification of infant deaths varied by scenario. For 3 scenarios portraying potential airway obstruction and negative autopsy findings, 61% to 69% classified the death as suffocation/asphyxia. In the last scenario, which portrayed a healthy infant in a safe sleep environment with negative autopsy findings, medical examiners and coroners classified the death as sudden infant death syndrome (38%) and SUID (30%). Reliance on investigative procedures to determine cause varied, but 94% indicated using death scene investigations, 88% full autopsy, 85% toxicology analyses, and 82% medical history review. CONCLUSIONS: US medical examiners and coroners apply variable practices to classify and investigate SUID, and thus, they certify the same deaths differently. This variability influences surveillance and research, impacts true understanding of infant mortality causes, and inhibits our ability to accurately monitor and ultimately prevent future deaths. Findings may inform future strategies for promoting standardized practices for SUID classification. |
| Databáze: | OpenAIRE |
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