Mortality at the Pediatric Emergency Unit of the Mohammed VI Teaching Hospital of Marrakech

Abstract

Background : The death of a child at the emergency ward is one of the most difficult problems that the clinicians of these wards have to deal with. In our country the published data concerning the causes and the factors related to pediatric mortality especially in the pediatric emergency wards is very rare. This study aimed to study the epidemiology of the pediatric mortality in the pediatric emergency department (PED), to determine its rate and identify its most frequent causes. Methods : It is a retrospective and descriptive study, over five years (1st January 2012 and 31st December 2016) including all children aged from 0 to 15 years old who died at the PED in the Mohamed VI Hospital in Marrakech. Results : During the period of the study a total of 172.691 patients presented to the PED, among which 628 died (pediatric mortality rate : 3.63%). The masculine gender was predominant (n=383) with a gender ratio of 1.59. Two-thirds of the patients died in the first 24 hours (n=421). The median of time from admission to death was around 12 hours. Majority of the deceased children (n=471, 75%) were from a low socioeconomic status. The most frequent cause of admissions for deceased patients in the PED was respiratory distress (n=296, 47%) followed by neurological disorders (n=70, 11%). Neonatal mortality (≤ 1 month of age) was predominant (n=472, 75.1%), followed by postnatal mortality (1 month to 1 year old) (n=73, 11.6%). The most frequent causes of pediatric mortality, whatever the age range, were dominated by neonatal pathologies (n=391, 62.3%), followed by infecious causes bronchopulmonary infections included (n=49, 7.7%), birth deformities (n=46, 7.3%) while traumas were merely at 0.9% (n=6). The most frequent causes of neonatal mortality were neonatal infections (n=152, 32.2%) and prematurity (n=115, 24.4%). Conclusion : Our data once again underline the crucial importance of prevention. This requires correct follow-up of the pregnancies, an adequate assistance of births, and perfecting healthcare provision to newborns in order to attain proper assistance.