In-Hospital Pediatric Mortality Tied to Patient Characteristics

Reducing variability among and within institutions could help improve mortality rates
By Monica Smith
HealthDay Reporter

MONDAY, May 10 (HealthDay News) -- Patient characteristics, including age and severity of diagnosis are substantive factors associated with pediatric in-patient deaths, and reducing variability within and between pediatric hospitals may improve mortality rates, according to research published online May 10 in Pediatrics.

Anthony D. Slonim, M.D., of the Children's National Medical Center in Washington, D.C., and colleagues performed a non-concurrent cohort study of 427,615 children hospitalized in 2005 in 37 academic children's hospitals, 4,529 (1.1 percent) of whom died, to gain a broader understanding of inpatient deaths.

The researchers found the highest mortality rate among neonates (4.03 percent), followed by patients over 18 (1.4 percent). The mortality rate was lowest among children 6 to 12 years of age (0.48 percent). Females were less likely to die than males, and children hospitalized with minor severity levels were less likely to die than those with extreme severity levels. There was considerable variation in deaths among institutions in both the number of children who died and the standardized mortality rates and ratios.

"Patient characteristics, such as age, severity, and diagnosis, were all substantive factors associated with the death of children. Opportunities to improve the environment of care by reducing variability within and between hospitals may improve mortality rates for hospitalized children," the authors write.

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