Analysis of Mortality due to Hemato-Oncological Pediatrics Malignancies in Public Hospitals in Argentina

Abstract

INTRODUCTION: In Argentina, the mortality of pediatric malignant diseases occupies an important place and their causes have not yet been studied in the country. OBJECTIVE: To analyze mortality rates, causes and moment of death related to neoplasias in selected public centers from January 2000 until December 2010. METHODS: The analysis was conducted in clinical records of patients who died due to cancer. The cases were registered in the Argentine Hospital Oncopediatric Registry (ROHA) and by different registries belonging to hemato-oncological departments. Mortality causes were classified according to the phase of therapy when the event occurred and the relationship of death with the treatment or underlying disease. Causes of comorbility and delays in diagnosis/treatment were also analyzed. RESULTS: In 13 centers, more than 70% of the deaths were successfully analyzed, while there was information of 35% for the remaining ones. Lethality (number of deaths compared to number of diagnoses during the period of time) was >40% in three centers, ≥30% in seven and <25% in four. At a center with a lethality >30% during the first five years of the analyzed period, the rate decreased to <25% in the following years. The main cause of death during early phases of diagnosis and treatment was related to severe infectious complications. CONCLUSIONS: It is fundamental to develop appropriate health policies in order to decrease mortality rates among children with cancer in Argentina. They should include programs for structural reform, human resource development and equipment supply, as well as continuous cooperative work.