Mortality Outcomes Following Pediatric Emergency Department Visits: A Systematic Review and Meta-Analysis.

Abstract

Background: Emergency departments with high readiness to admit children may reduce mortality rates, but comprehensive and comparative evidence is limited. This study is the first systematic review and meta-analysis conducted to determine the effect of pediatric emergency department readiness on in-hospital mortality.

Methods: A search for relevant articles was conducted up to 17 December 2025 in the international databases PubMed, EMBASE, Scopus, and Web of Science. Relevant keywords were used for the search. Current study question: In children presenting to emergency departments (Population), how is the level of emergency readiness for pediatric care (Exposure) associated with mortality (Outcome)? This section was created using the PICO approach. Data analyses were conducted using the meta-analysis packages in STATA/MP.v17 (College Station, Texas, USA).

Results: The overall in-hospital mortality rate was estimated to be about 2%. Meta-analysis showed that care at highest-readiness EDs (Quartile 4 wPRS) was associated with a significant reduction in mortality (OR=0.617; 95% CI, 0.491-0.744).

Conclusion: Increasing the level of emergency department pediatric readiness can be associated with a reduction in in-hospital mortality. These findings highlight the importance of policy to improve standards of pediatric emergency readiness in all hospitals.