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Mortality in Spanish pediatric emergency departments: a 5-year multicenter survey
Edurne Lopez1, June Udaondo, Mikel Olabarri
1Pediatric Emergency Department, Cruces University Hospital, University of the Basque, Country, Basque Country, Spain.
Insights
In Spanish pediatric emergency departments, the primary causes of child mortality include pre-existing conditions, sudden infant death syndrome, and trauma. Improving prehospital and emergency care is crucial for these vulnerable patients.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Child Mortality Analysis
Background:
- Child mortality in pediatric emergency departments (EDs) requires analysis to inform management and prevention strategies.
- Understanding causes of death is vital for improving pediatric emergency care.
Purpose of the Study:
- To identify the leading causes of death in children within Spanish pediatric EDs.
- To examine the prehospital and hospital management of critically ill children.
Main Methods:
- Retrospective, descriptive, multicenter survey of pediatric deaths.
- Data collected from 18 Spanish pediatric EDs between 2008 and 2013.
- Analysis included patient demographics, causes of death, and resuscitation efforts.
Main Results:
- A total of 54 pediatric deaths occurred among over 3.5 million visits (mortality rate: 1.5/100,000).
- Leading causes of death were previous illnesses (24.5%), sudden infant death syndrome (20.7%), and trauma (18.8%).
- Cardiopulmonary resuscitation (CPR) was frequently administered, particularly in medically transported patients.
Conclusions:
- Key drivers of pediatric mortality in Spanish EDs are chronic conditions, SIDS, and unintentional injuries.
- Enhancements in prehospital and emergency care protocols are recommended to improve outcomes for critically ill children.
Background:
Analysis of the causes of death in children in the pediatric emergency department (ED) may aid the development of management and prevention practices.
Objective:
To identify the causes of death in Spanish pediatric EDs and to analyze the management of these children in the prehospital and hospital settings.
Methods:
This was a retrospective descriptive multicenter survey including all patients whose death was certified in 18 Spanish pediatric EDs between 2008 and 2013.
Results:
During the study period, 3 542 426 episodes were registered in the EDs. Of these, 54 patients died (mortality rate: 1.5/100 000 visits). Data of 53 patients are analyzed (male 36, 67%, 31 younger than 2 years old and 43.3% nonpreviously healthy children). The main causes of death were related to their previous illnesses (24.5%), sudden infant death syndrome (20.7%), and traumatism (18.8%).Prehospital cardiopulmonary resuscitation (CPR) was performed in 31 patients, and exclusively by health workers in 19 patients. In 35 patients, the parents witnessed the event and seven began CPR.Thirty children were transferred to the pediatric EDs by medical transport (56.6%) and all of them received prehospital CPR (vs. one patient out of 23 arrived in a nonmedical transportation).In 37 patients, CPR was performed in the pediatric EDs. Overall, CPR lasted 40±23 min (range, 10-120 min). CPR was not performed in seven patients at any time.
Conclusion:
The main causes of death in Spanish pediatric EDs are related to previous illnesses, sudden infant death syndrome, and nonintentional lesions. Several actions have to be considered to improve the quality of care of these children in prehospital and emergency settings.
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