SynthesisBMC emergency medicine2025
Mortality predictors in pediatric emergency department presentations: a systematic review and meta-analysis.
Synthesis in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Mortality predictors in pediatric emergency department presentations: a systematic review and meta-analysis.BMC emergency medicine · 2025Pooled it
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPediatric patients present to the emergency departments (EDs) with a wide range of clinical manifestations, ranging from mild to severe. A systematic approach is crucial to identify those at high risk of deterioration. However, the predictive value of such predictors remains unclear.
objectivesOur study aims to evaluate different mortality predictors used in pediatric emergency departments (PEDs) regarding the diagnostic accuracy metrics, including sensitivity, specificity, and diagnostic odds ratio.
methodsWe comprehensively searched multiple databases and included all cohort studies, case-control studies, and randomized controlled trials from January 2000 to December 2024 with pediatric patients (aged 0-18 years) presenting to PEDs, where mortality predictors were used to assess for in-ED and short-term post-ED mortality. We employed a bivariate random-effects model for data synthesis and analysis to calculate pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC) values.
results329 Pediatric Early Warning Score (PEWS) thresholds were analyzed, with the model-derived optimal cutoff 2.189 (AUC) = 0.70; 95% CI: 0.63 to 0.76), high pooled sensitivity (0.95, 95% CI: 0.72 to 0.80) and specificity (0.93, 95% CI: 0.62 to 0.80). In addition, A strong negative predictive value (NPV = 0.0006) and modest positive predictive value (PPV = 0.0003) were noted. Heterogeneity was significant (I²>99%), driven by PEWS versions and clinical settings. PEWS implementation reduced mortality without increasing ICU admissions in resource-limited settings.
conclusionsPEWS is a good exclusion tool for those at low mortality risk. However, a comprehensive approach with clinical judgment is needed for the risk assessment of high-risk pediatrics.
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