Changes in Emergency Department Pediatric Readiness and Mortality

Area of Science:

• Emergency Medicine
• Pediatric Trauma Care
• Healthcare Quality Improvement

Background:

• High emergency department (ED) pediatric readiness is linked to better survival rates in children.
• The impact of changes in ED pediatric readiness on pediatric mortality remains largely unknown.

Purpose of the Study:

• To assess the association between changes in ED pediatric readiness scores (wPRS) from 2013 to 2021.
• To evaluate the impact of these changes on pediatric mortality in US trauma centers.

Main Methods:

• Retrospective cohort study of injured children (<18 years) admitted to US trauma centers (2012-2021).
• Analysis of changes in weighted Pediatric Readiness Score (wPRS) between 2013 and 2021.
• Risk-adjusted logistic regression to evaluate the association between ED readiness changes and mortality.

Main Results:

• The study included 467,932 children across 417 trauma centers.
• While not statistically significant, trends suggested high-readiness EDs saved more lives and low-readiness EDs had more preventable deaths.
• A wPRS threshold of 90 or higher may optimize lives saved.

Conclusions:

• Findings suggest increasing ED pediatric readiness is crucial for reducing pediatric mortality.
• Trauma centers should prioritize enhancing pediatric readiness to improve outcomes for injured children.
• Despite non-significant results, the trend supports proactive improvements in pediatric emergency care.