Risk Factors Predicting Early In-Hospital Mortality among Underfive Children and Need for Decentralization of Pediatric Emergency Care Services

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dc.contributor.authorSoni, Adityaen_US
dc.contributor.authorKhalil, Sumairaen_US
dc.contributor.authorPandey, R. M.en_US
dc.contributor.authorChellani, Harishen_US
dc.date.accessioned2023-08-19T04:55:50Z
dc.date.available2023-08-19T04:55:50Z
dc.date.issued2022-09
dc.description.abstractBackground: Lack of pediatric triage and emergency care system in peripheral healthcare centers leads to unnecessary referral of low- and medium?risk patients. This study was conducted to study the risk factors predicting mortality within 48 h of admission in neonates and under?five children referred to the pediatric emergency of a tertiary care hospital in India. Methods: This prospective study was conducted on children (0–5 years) referred to the pediatric emergency who were enrolled and followed up. The outcome was defined as “survival” or “death” at 48 hours. Logistic regression analysis was conducted to assess the predictors of early in?hospital mortality. Results: A total of 246 consecutive pediatric (62 neonates, 52 young infants, and 132 children aged 1–5 years) referral cases were enrolled; mortality within 48 hours was 20%. Lack of pediatric intensive care (odds ratio [OR] 4.07, 95% confidence interval [CI] 2.0, 8.32, P = 0.02), lack of neonatal intensive care (OR 2.10, 95% CI 1.01,4.28, P ? 0.001), distance from referral center >20 km (OR 4.61, 95% CI 2.01, 10.58, P = 0.0003), >1 h taken during transport (OR 7.75, 95% CI 2.93, 20.46, P < 0.001), lack of ambulance facility (OR 0.04, 95% CI 0.009, 0.143, P < 0.0001), very sick condition on arrival (OR 210.1, 95% CI 12.1, 3643.41, P = 0.0002), and unstable temperature?oxygenation?perfusion?sugar on arrival were the independent risk factors predicting in early in-hospital mortality. Conclusion: Developing a pediatric triage and monitoring system, tele-pediatric intensive care unit, regionalizing referral-back-referral services with robust interhospital communication, and strengthening pediatric emergency services are the need of the hour to reduce early in-hospital mortalityen_US
dc.identifier.affiliationsSenior Resident, Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospitalen_US
dc.identifier.affiliationsProfessor, Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospitalen_US
dc.identifier.affiliationsAssistant Professor, Department of Pediatrics, University College of Medical Science & GTB Hospitalen_US
dc.identifier.affiliationsProfessor and Head, Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, Indiaen_US
dc.identifier.citationSoni Aditya, Khalil Sumaira, Pandey R. M., Chellani Harish. Risk Factors Predicting Early In-Hospital Mortality among Underfive Children and Need for Decentralization of Pediatric Emergency Care Services. Indian Journal of Public Health. 2022 Sept; 66(3): 257-263en_US
dc.identifier.issn0019-557X
dc.identifier.issn2229-7693
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/223828
dc.languageenen_US
dc.publisherWolters Kluwer – Medknowen_US
dc.relation.issuenumber3en_US
dc.relation.volume66en_US
dc.source.urihttps://doi.org/10.4103/ijph.ijph_487_22en_US
dc.subjectDeathen_US
dc.subjectemergencyen_US
dc.subjectmedical auditen_US
dc.titleRisk Factors Predicting Early In-Hospital Mortality among Underfive Children and Need for Decentralization of Pediatric Emergency Care Servicesen_US
dc.typeJournal Articleen_US
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