Primary outcome: mortality
| Publication | Intervention v. comparator | Primary outcome | Primary outcome effect estimate | Primary outcome results (unadjusted) | Variables used to adjust primary outcome | Primary outcome results (adjusted) | Conclusion |
|---|---|---|---|---|---|---|---|
| Ames et al.,9 2019 | High WPRS v. low WPRS | Mortality | OR | NA | Age, chronic complex conditions, and severity of illness | WPRS associated with presenting hospital and in-hospital mortality in quartiles, OR (95% CI), p value: Q1 (WPRS 30–59): 1.00 (ref.) Q2 (WPRS 59–75): 0.52 (0.30–0.90), p = 0.018 Q3 (WPRS 75–88): 0.36 (0.22–0.58), p < 0.001 Q4 (WPRS 88–100): 0.25 (0.18–0.35), p < 0.001 | This study showed that critically ill children presenting to hospitals with a high pediatric readiness score is associated with decreased mortality. Efforts to increase ED readiness for pediatric emergencies may improve patient outcomes. |
| Newgard et al.,19 2021 | High WPRS v. low WPRS | Mortality | OR | ED pediatric readiness score association with in-hospital mortality, OR (95% CI), p value: Non-transfer patients (n = 317005) Q1 (least ready): ref., p = 0.077 Q2: 1.34 (0.97–1.86) Q3: 1.01 (0.74–1.36) Q4 (most ready): 0.69 (0.51–0.92) Transferred patients (n = 54999) Q1 (least ready): ref., p = 0.033 Q2: 0.99 (0.65–1.49) Q3: 0.84 (0.58–1.22) Q4 (most ready): 0.59 (0.39–0.90) | Demographic characteristics (age, sex, race), comorbidities, initial physiology (age-adjusted hypotension), emergent airway intervention, mechanism of injury, ISS, transfer status, blood transfusion, nonorthopedic surgery, orthopedic surgery, and geographic region | WPRS associated with in-hospital mortality, OR (95% CI): Q1 (WPRS 32–69): 1.00 (ref.) Q2 (WPRS 70–87): 1.16 (0.87–1.54) Q3 (WPRS 88–94): 0.90 (0.70–1.17) Q4 (WPRS 95–100): 0.58 (0.45–0.75) | In this cohort study, injured children treated in high-readiness EDs had lower mortality compared with similar children in low-readiness EDs, but not fewer complications. These findings support national efforts to increase ED pediatric readiness in US trauma centres that care for children. |
| Newgard et al.,22 2022 | High WPRS v. low WPRS | Mortality | OR | NA | Demographic characteristics (age, sex, race), comorbidities, age-adjusted hypotension, emergent airway intervention, blood transfusion, mechanism, ISS, interhospital transfer, and year of visit | WPRS associated with in-hospital mortality comparing the highest v. lowest quartiles of ED pediatric readiness, OR (95% CI): Q1 (WPRS 32–69): 1.00 (ref.) Q2 (WPRS 70–87): NA Q3 (WPRS 88–94): NA Q4 (WPRS 95–100): 0.61 (0.42–0.89) | This study showed that children treated in high-readiness trauma centre EDs after injury had a lower risk of death that persisted to 1 year. These findings further support the importance of ED pediatric readiness and the imperative for US trauma centres to meet the high level of ED readiness required to reduce pediatric mortality after injury. |
| Balmaks et al.,24 2020 | High WPRS v. low WPRS | Mortality | OR | NA | Nesting of patients in each ED, and patient demographics | 1-point increase in WPRS is associated with 6-mo mortality, OR (95% CI), p value: OR = 0.93 (0.88–0.98), p = 0.011 (re-scaled into OR of 0.93^17 = 0.29 for an increase of 1 interquartile range, which equals 0.87 at the highest quartile) | This study nationally assessed that pediatric readiness in EDs, in Latvia was associated with shorter ICU length of stay, shorter hospital length of stay and lower 6-mo mortality. |
Note: CI = confidence interval, ED = emergency department, ISS = Injury Severity Score, NA = not available, OR = odds ratio, Q = quartile, Ref. = reference, SD = standard deviation, WPRS = weighted pediatric readiness score.