Emergency Department Preparedness Reduces Mortality Risk in Children

Emergency departments in highest quartile of pediatric readiness had lower in-hospital mortality among injured and medically ill children.

HealthDay News Emergency departments with high pediatric readiness have lower short-term and long-term mortality among children, according to a study published online Jan. 13 in JAMA Network Open.

Craig D. Newgard, M.D., from the Oregon Health & Science University in Portland, and colleagues assessed associations between high pediatric readiness and in-hospital mortality and one-year mortality among injured and medically ill children receiving emergency care in 11 states. Pediatric readiness was measured using the weighted Pediatric Readiness Score (range, 0 to 100) with six domains of preparedness (coordination, personnel, quality improvement, safety, policies, and equipment). The analysis included 796,937 children receiving emergency care at 983 emergency departments from 2012 through 2017.

The researchers found that compared with emergency departments in the lowest quartile of readiness (quartile 1, readiness score of 0 to 58), initial care in a quartile 4 emergency department (readiness score of 88 to 100) was associated with lower in-hospital mortality among injured children (adjusted odds ratio, 0.40) and lower in-hospital mortality among medically ill children (adjusted odds ratio, 0.24). A similar trend was seen for mortality among the 545,921 children followed to one year (adjusted hazard ratios in quartile 4 emergency departments, 0.59 for injured children and 0.34 for medically ill children). An estimated 288 deaths among injured children and 1,154 deaths among medically ill children may have been prevented if all emergency departments were in the highest quartile of pediatric readiness.

“The optimal solution is to promote policies and incentives to increase emergency department pediatric readiness among all U.S. hospitals, including rural and frontier regions,” the authors write.

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