Outcomes of emergency admissions and associated factors among children admitted to the pediatric emergency unit of public hospitals in Addis Ababa, Ethiopia, Retrospective Cross- sectional study

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Abstract Background: - Pediatric emergency condition is a life-threatening process that, without timely and standard clinical intervention, may lead to death. Therefore, it requires proper emergency care as it is the only option of management to save a life. The purpose of this study is to assess outcomes of emergency admissions and associated factors among children admitted to the pediatric emergency of selected public hospitals in Addis Ababa, Ethiopia, in 2022. Methods and materials: -An institutional-based retrospective cross-sectional study design was conducted on children admitted emergency unit/ward from January 02, 2020, to January 08, 2022, in the emergency unit of randomly selected public hospitals. Data were extracted with the prepared checklists from February 1 to March 1 2022 for a total sample of 303 admitted children charts calculated using simple population proportion formula. The collected data were entered and cleaned using SPSS version 23 for analysis of bivariate logistic regression used to check the association of variables. Result: A total of 303 admitted children’s charts were reviewed with 100% coverage and the mean age of children was 37.47 months and male to female ratio was 1.16:1. The study revealed that the most common causes of emergency admission were pneumonia (22.4%), surgical emergencies (14.5%) late-onset sepsis (9.2%) respectively. More than half (53.8%) of children were admitted to Pediatric Emergency Department for less than 24 hours and the mean length of stay was 2 days. 39.6% of children were discharged with clinical improvement. Known comorbidity (AOR=4.65, 95% CI (1.23-17.64)), fluid treatment (AOR=0.14, 95% CI (0.02-0.93)), and length of stay less than 24 hours (AOR=4.2, 95% CI (1.2-14.7)) were strongly associated with the outcome. Conclusion: - pneumonia is still the most common cause of pediatric emergency admission and the mortality rate of children at the Pediatric Emergency Department is high, known comorbidity, and length of stay less than 24 hours in the emergency department had a significant association with mortality. FMOH and Policymakers recommended developing national pediatric emergency care guidelines for standard management and timely intervention, providing skill gap training through technology support for healthcare workers and parents should be informed on the use of early case detection and management.

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