title: The mortality of patients in a pediatric emergency department at a tertiary medical center in China: An observational study.
abstract: BACKGROUND
  The quality of treatment for critically ill children varies widely at different hospitals. This study aimed to analyze the characteristics of mortality in a pediatric emergency department (PED) at a tertiary children's hospital in Guangzhou, China and to investigate the risk factors associated with the mortality.
  
  
  METHODS
  The mortality of pediatric patients at the hospital from 2011 to 2013 was retrospectively analyzed using descriptive statistics.
  
  
  RESULTS
  Altogether 466 919 patients visited the PED during the period and 43 925 of them were admitted for further observation. In 230 deaths, the ratio of boys to girls was 1.4:1, and their age ranged from 2 hours to 16 years (median, 5 months). The time from admission to death ranged from 0 to 216 hours (median, 1.5 hours). There were 92 (40%) patients who died within 24 hours after admission and 104 (45.2%) patients who died on arrival. The prominent causes of the deaths were respiratory diseases, neuromuscular disorders, cardiovascular diseases, and sepsis, most of which were ascribed to severe infection. Sixty-five deaths were associated with more than one concomitant problem. The top concomitant problems were congenital malformation, low gestational age, and severe birth asphyxia.
  
  
  CONCLUSIONS
  In our center, 40% of the patients in the PED died of fatal acute diseases, and pneumonia was the first leading cause of the deaths. Almost half of the deaths occurred on arrival and the rest were due to end-stage malignant diseases. This study emphasized the importance of prevention of birth deficits by reducing deaths in infants and children.
authors.affiliation: Division of Emergency Medicine, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China.
authors.forename: Cui-Ping
authors.initials: CP
authors.lastname: Zhu
authors.affiliation: Division of Emergency Medicine, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China.
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Wu
authors.affiliation: Division of Emergency Medicine, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Liang
authors.affiliation: Division of Emergency Medicine, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Ma
authors.affiliation: Division of Emergency Medicine, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Ren
keywords: Developing counties; Mortality; Pediatric emergency department