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Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010)

  • Quantitative Research
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Abstract

OBJECTIVE: The goals of analyzing all non-natural childhood deaths in Manitoba for the 22-year period (1989–2010) are to highlight preventable causes of death and to document temporal trends that might be influenced by changes in society.

METHODS: The 1989 to 2010 pediatric autopsy database at the Winnipeg Health Sciences Centre and records from the Office of the Chief Medical Examiner were searched for all non-natural deaths ≤ 18 years age. All files were reviewed in detail. Data collected included demographic characteristics, manner of death, details of cause and circumstances leading to death, and survival time after the event.

RESULTS: For the 22-year period, the total number of non-natural childhood deaths after which autopsy was performed in Manitoba was 581 for males and 409 for females in a population of approximately 1.23 million (2010 estimate). This represents 22.1 % of the total childhood deaths in Manitoba during the study period. A higher proportion of children living in rural and northern communities died from non-natural causes. Of all accidents, which peaked in 1999, road traffic incidents accounted for the majority. Of suicides, which peaked in 2005, hanging in the 15-18 year group accounted for almost all cases. Of homicides, child abuse deaths at <3 years age was the most frequent cause. For all causes, most individuals were dead at the scene or died shortly thereafter.

CONCLUSIONS: Most non-natural childhood deaths in Manitoba might be avoidable through education about prevention strategies and by correction of social inequities. Improved transportation to hospital from remote locations would likely have little impact on survival.

Résumé

OBJECTIF: Notre analyse de tous les décès d’enfants de causes non naturelles au Manitoba sur une période de 22 ans (1989–2010) vise à faire ressortir les causes de décès évitables et à décrire les tendances temporelles qui pourraient être influencées par les changements sociétaux.

MÉTHODE: Nous avons interrogé la base de données des autopsies pédiatriques de 1989 à 2010 du Centre des sciences de la santé de Winnipeg et les dossiers du Bureau du médecin légiste en chef pour obtenir tous les décès de causes non naturelles d’enfants de ≤ 18 ans. Les dossiers ont été examinés en détail. Les données recueillies incluaient le profil démographique, le mode de décès, les causes et les circonstances ayant conduit au décès, ainsi que la durée de survie après l’événement.

RÉSULTATS: Sur la période d’étude de 22 ans, le nombre total de décès d’enfants de causes non naturelles suivis d’une autopsie au Manitoba était de 581 pour les garçons et de 409 pour les filles pour une population d’environ 1,23 million d’habitants (estimation de 2010). Ceci représente 22,1 % des décès d’enfants au Manitoba sur la période de l’étude. Une proportion plus élevée d’enfants vivant dans les communautés rurales et nordiques est décédée de causes non naturelles. Les accidents de la route ont représenté la majorité des accidents, lesquels ont atteint un sommet en 1999. Pour les suicides, qui ont atteint un sommet en 2005, les pendaisons dans le groupe des 15 à 18 ans ont représenté presque la totalité des cas. Pour les homicides, les décès résultant de la maltraitance d’enfants de <3 ans étaient la cause la plus fréquente. Pour toutes les causes de décès, la plupart des sujets ont été trouvés morts sur les lieux ou sont décédés peu après.

CONCLUSIONS: La plupart des décès d’enfants de causes non naturelles au Manitoba pourraient être évités par la sensibilisation aux stratégies de prévention et par le redressement des iniquités sociales. L’amélioration du transport à l’hôpital à partir des endroits éloignés aurait sans doute peu d’impact sur la survie.

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Author notes

  1. Jayantha C. Herath MD, FRCPC

    Present address: Ontario Forensic Pathology Service and University of Toronto, Toronto, ON, Canada

Authors and Affiliations

  1. Department of Pathology, University of Manitoba, and Diagnostic Services Manitoba, Winnipeg, MB, Canada

    Jayantha C. Herath MD, FRCPC, Susan M. Phillips MD, FRCPC & Marc R. Del Bigio MD, PhD, FRCPC

  2. Faculty of Medicine (Postgraduate Medical Education), University of Manitoba, Winnipeg, MB, Canada

    Saman Kalikias MD

Authors
  1. Jayantha C. Herath MD, FRCPC
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  2. Saman Kalikias MD
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  3. Susan M. Phillips MD, FRCPC
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  4. Marc R. Del Bigio MD, PhD, FRCPC
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Corresponding author

Correspondence to Marc R. Del Bigio MD, PhD, FRCPC.

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Conflict of Interest: None to declare.

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Herath, J.C., Kalikias, S., Phillips, S.M. et al. Traumatic and other non-natural childhood deaths in Manitoba, Canada: A retrospective autopsy analysis (1989–2010). Can J Public Health 105, e103–e108 (2014). https://doi.org/10.17269/cjph.105.4156

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  • DOI: https://doi.org/10.17269/cjph.105.4156

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