Prevalence and associated factors of pediatric emergency mortality at Tikur Anbessa specialized tertiary hospital: a 5 year retrospective case review study

Abstract

BackgroundChildhood mortality remains high in resource-limited third world countries. Most childhood deaths in hospital often occur within the first 24 h of admission. Many of these deaths are from preventable causes. This study aims to describe the patterns of mortality in children presenting to the pediatric emergency department.MethodsThis was a five-year chart review of deaths in pediatric patients aged 7 days to 13 years presenting to the Tikur Anbessa Specialized Tertiary Hospital (TASTH) from January 2012 to December 2016. Data were collected using a pretested, structured checklist, and analyzed using the SPSS Version 20. Multivariate analysis by logistic regression was carried out to estimate any measures of association between variables of interest and the primary outcome of death.ResultsThe proportion of pediatric emergency department (PED) deaths was 4.1% (499 patients) out of 12,240 PED presentations. This translates to a mortality rate of 8.2 deaths per 1000 patients per year. The three top causes of deaths were pneumonia, congestive heart failure (CHF) and sepsis. Thirty two percent of the deaths occurred within 24 h of presentation with 6.5% of the deaths being neonates and the most common co-morbid illness was malnutrition (41.1%).Multivariate analysis revealed that shortness of breath [AOR=2.45, 95% CI (1.22-4.91)], late onset of signs and symptoms [AOR=3.22, 95% CI (1.34-7.73)], fever [AOR=3.17, 95% CI (1.28-7.86)], and diarrhea [AOR=3.36, 95% CI (1.69-6.67)] had significant association with early mortality.ConclusionThe incidence of pediatric emergency mortality was high in our study. A delay in presentation of more than 48 hours, diarrheal diseases and shortness of breath were significantly associated with early pediatric mortality. Early identification and intervention are required to reduce pediatric emergency mortality.

Mortality at the pediatric emergency unit of the Mohammed VI teaching hospital of Marrakech

“…This observation is reported in other studies especially from Africa [5,7]. Two-thirds of our patients died in the first 24 h compared to 32% for Jofiro et al [8]. Our median of the period of stay in the PED was 12 h largely exceeding that of Zhu which was around 1,5 h [10].…”

“…During our study period, the mortality rate was at 3.63 per 1000. While comparing our results to similar available series from countries outside of Morocco, we found that our rate was way underneath that of the Bassey et al [5] study with 27 per 1000, the Robison et al [6] study (37.9 per 1000), the Ndu et al [7] study (58 per 1000), the Joffiro et al [8] study (41 per 1000) and the Santhanam study (122 per 1000) [9]. These disparities can be explained at least partially by the socio-economic level of each country.…”

The magnitude and Associated Factors of Pneumonia Among Under-Five Children in Ethiopia: A Systematic Review and Meta-Analysis

“…In this meta-analysis and systematic review, of the total 12 included studies, four studies were conducted from Amhara region [2,[22][23][24], four studies from Oromia region [25][26][27][28], two studies from SNNP [20,21], two studies from Addis Ababa [29,30] (Table 1).…”

“…The magnitude of Pneumonia Among Under Five Children in Ethiopia from included studies ranged between 4.1% to 39.6% [24,30]. As indicated in the forest plot below, the pooled magnitude of Pneumonia Among Under Five Children from 12 studies in Ethiopia was 20.68% (95% CI: 12.49, 28.88).…”

Determinants of community-acquired pneumonia among children aged from 2 to 59 months in Fitche General Hospital: a case control study

“…10 In our previous ve-year retrospective study on mortality of pediatrics, pneumonia was the rst rank of the top ten diseases of mortality. 11 Pneumonia has many possible causes, but the most common etiology of community-acquired pneumonia in children under-ve years of age are bacteria and viruses. The most common causes of bacterial pneumonia are Streptococcus pneumoniae, causing more than 76% of bacterial pneumonia cases.…”