Peds Mortality Down for Presentation at ED With Higher Readiness

Presentation to hospitals with an emergency department with high levels of readiness to care for pediatric emergencies is associated with reduced mortality, according to a study published online in Pediatrics.

Stefanie G. Ames, M.D., from the University of California in Los Angeles, and colleagues conducted a retrospective cohort study focusing on patients aged 0 to 18 years with critical illness. The correlation between hospital-specific pediatric readiness and encounter mortality was examined in the entire cohort and in condition-specific subgroups. Data were included for 20,483 critically ill children presenting to 426 hospitals.

The researchers found that the median weighted pediatric readiness score was 74.8. With increasing readiness score, there was a decrease in unadjusted in-hospital mortality (mortality by lowest to highest readiness quartile: 11.1, 5.4, 4.9, and 3.4 percent, respectively). Presentation to a hospital in the highest readiness quartile correlated with reduced odds of in-hospital mortality after adjustment for age, chronic complex conditions, and severity of illness (adjusted odds ratio versus lowest quartile, 0.25). In specific subgroups, the results were similar.

"Presentation to a hospital with lower pediatric readiness is associated with increased risk of death for children with critical illness," the authors write. "Efforts are needed to improve the pediatric readiness of emergency departments that care for children, ensuring critically ill children have access to timely, well-resourced, and effective emergency care."

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