Clinical and Health System Factors Associated with Pediatric Brought-Dead Cases at a Tertiary Care Hospital in...

Area of Science:

• Pediatric Mortality
• Public Health
• Emergency Medicine

Background:

• Pediatric deaths before hospital arrival indicate significant health system weaknesses, especially in low- and middle-income countries.
• Respiratory illnesses are a major cause of mortality in young children.
• Gaps in pre-hospital care and referral systems contribute to preventable deaths.

Purpose of the Study:

• To analyze the causes and contributing factors of pediatric deaths occurring before hospital arrival.
• To identify delays in seeking and receiving medical care for critically ill children.
• To provide evidence for strengthening pre-hospital emergency services in India.

Main Methods:

• Retrospective observational study of pediatric cases (1 month to 12 years) brought dead to a tertiary care hospital in Karnataka, India.
• Data collected between July 2024 and June 2025, analyzing 52 cases.
• Investigated caregiver actions, prior medical care utilization, pre-referral treatment, and reasons for delays.

Main Results:

• Infants (42.3%) and respiratory illnesses (57.7%) were predominant among the analyzed cases.
• Despite 94.2% seeking prior medical care, only 42.3% used ambulance services, and nearly half received no pre-referral treatment.
• Caregiver decision-making contributed to delays (11.5%), with chronic illness being a significant factor in both cause of death and care delays.

Conclusions:

• Cumulative delays across the continuum of care contribute to pre-hospital pediatric mortality.
• Strengthening early illness recognition and pre-hospital emergency services is vital.
• Addressing systemic gaps in referral and pre-hospital care can reduce preventable child deaths.