Disease Spectrum and Mortality in Hospitalized Children of Southern Iran

Objective: In medicine, especially in the field of pediatrics, it is necessary to perform regular epidemiologic studies in each geographic region. We designed this study in Nemazee Hospital, Shiraz (the major referral pediatric center in Southern Iran), to determine the disease spectrum, the mortality and also the rate of matching final diagnosis with the initial impression in pediatric wards.
Material & Methods: All children older than 1 month (2731) who were admitted in Nemazee Hospital (except for surgical wards), from November 2005 to October 2006, were studied through questionnaire interviewing on admission and were followed till discharge or expire time. In some instances that final diagnosis or cause of death was unclear; we followed them through their files in clinics up to 1 year.
Findings: Among 3057 admissions (related to 2731 patients), 56.8% were males (male to female ratio: 1.31). Patients’ age was 31 days to 25 years (mean: 5.16 years, SD: 4.98 years) and the significant portion was less than 2 years (1270= 44.2%). Admission duration varied from 1 to 62 days (mean: 5 days, SD: 5.13 days). The most common diseases were seizure disorder (315=11.1%), pneumonia (235=7.7%), febrile convulsion (136=4.79%) and gastroenteritis (128=4.18%). 17.93% of admissions came out of Fars Province (18 Provinces) with digestive system (19.1%), infectious (18.5%) and nervous system diseases (15.0%) as the most frequent referred patients. In 90.6% of admissions final diagnosis was clarified in the hospital (ranged from 86.45% in infectious ward to 93.4% in cardiology ward) (P=0.01). The total mortality rate was 5.30%; this rate was 9.49% for patients younger than 1 year and 5.0% in older patients (P<0.001).
Conclusion: The most common age of admission in pediatric wards was less than one year. The most common diseases were seizure disorder, pneumonia and gastroenteritis. Congenital heart disease, sepsis and pneumonia were the most common diseases leading to death.