Incidence of Pediatric Mortality in the Emergency Department: A Retrospective Study in Iran

Mohammad Mehdi  Rajabi; Alireza  Shojaei; Behdad  Gharib

doi:10.18502/jimc.v9i2.21178

Mohammad Mehdi Rajabi Department of Pediatric Nursing and Neonatal Intensive Care, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Alireza Shojaei Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Behdad Gharib Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v9i2.21178

Keywords: Child, Cause of death, Emergency service, Infant, Iran, Retrospective study

Abstract

Background: Pediatric Emergency Departments (EDs) play a vital role in identifying and managing life-threatening conditions in children. Despite global reductions in under-five mortality, pediatric mortality remains a significant public health concern, particularly in Low- and Middle-Income Countries (LMICs). Localized studies on mortality patterns in pediatric EDs are essential for developing targeted interventions. This study aimed to investigate the incidence of pediatric mortality in the emergency department of the Children’s Medical Center, a national referral hospital in Iran, from 2019 to 2022.

Methods: A retrospective study was conducted on children under 18 years of age who died in the ED during the study period. Data were collected from medical records, including demographic information, causes of death, and time of death. Descriptive statistics were used for analysis.

Results: Among 76187 pediatric admissions, 155 deaths occurred, yielding a mortality rate of 2.03 per 1000 admissions. The mean age of the deceased was 43.58±6.1 months, with a slight male predominance (52.9%). Infants had the highest mortality rate (32.3%), while neonates had the lowest (5.8%). Neurological disorders (36.1%) were the most common cause of death, followed by infectious diseases (29.0%), cardiological conditions (20%), and hematological disorders (12.3%). A significant proportion of deaths (40%) occurred within one hr before or two hours after shift changes.

Conclusion: The findings highlight the need to enhance neurocritical care and infection management in EDs. The high proportion of deaths near shift changes underscores the importance of effective handover protocols to improve patient safety.