ArticleBMC pediatrics2025
Frequency and profile of pediatric mortality in an emergency department: a retrospective cross-sectional study from a low-middle income country.
Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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7 authors.
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Abstract
backgroundPediatric mortality remains a significant challenge in low- and middle-income countries (LMICs), particularly in emergency care settings. This study aimed to evaluate the frequency, causes, and clinical characteristics of pediatric deaths in a tertiary emergency department (ED) in Pakistan.
methodsWe conducted a retrospective chart review of all pediatric patients (age 0-18 years) who died in the pediatric ED at Aga Khan University Hospital, Karachi, between January 2017 and December 2021. The ED serves a catchment population of approximately 25 million. Data were extracted on demographics, presenting complaints, comorbidities, triage level, cause of death, and ED stay duration.
resultsOf 91,607 pediatric ED visits during the study period, 357 children died (0.48%). After excluding 171 patients who were dead on arrival, 186 cases were included in the analysis. The median age was 24 months (range: 0-216 months), and 91 (48.9%) deaths occurred in children under one year of age. The median ED length of stay was 3.5 h (range: 1-21.7 h). Leading causes of death included sepsis/septic shock (61 cases, 33%), cardiopulmonary failure (25 cases, 13%), pneumonia (18 cases, 10%), and trauma (10 cases, 5%). Among children under five, pneumonia and gastroenteritis accounted for 30% of deaths. Due to the retrospective nature of the study, data on socioeconomic status, vaccination dropout, or family size were not available. All staff involved in care were Pediatric Advanced Life Support (PALS) and Neonatal Resuscitation Program (NRP).
conclusionPediatric mortality in the ED was predominantly driven by preventable infectious and trauma-related causes. Delayed presentation, limited ICU capacity, and advanced disease severity on arrival were major contributors to early deaths. Strengthening triage protocols, improving critical care access, and investing in early intervention strategies are essential.
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