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<p>Pediatric deaths occurring before hospital arrival reflect critical gaps in health systems, particularly in low- and middle-income settings. The authors conducted a retrospective observational study at a tertiary care hospital in Karnataka, India, including children aged 1 mo to 12 y brought dead between July 2024 and June 2025. Fifty-two cases were analyzed. Infants constituted 42.3%, and respiratory illnesses were the leading causes of death (57.7%). Although 94.2% of caregivers sought prior medical care, only 42.3% used ambulance services, and nearly half of the children received no pre-referral treatment. Delay in care was identified in 11.5% of cases, often related to caregiver decision-making. Chronic illness was significantly associated with both cause of death and delay in care. These findings highlight cumulative delays across the continuum of care. Strengthening early illness recognition, referral systems, and pre-hospital emergency services is essential to reduce preventable pediatric mortality.</p>

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Clinical and Health System Factors Associated with Pediatric Brought-Dead Cases at a Tertiary Care Hospital in Karnataka (India)

  • 期刊论文

  • 发表日期：

    2026年6月19日

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  • Likhita S.,
  • Vinod H. Ratageri,
  • Shivanand Illalu,
  • Keerthidarshini Khanappanavar

摘要

Pediatric deaths occurring before hospital arrival reflect critical gaps in health systems, particularly in low- and middle-income settings. The authors conducted a retrospective observational study at a tertiary care hospital in Karnataka, India, including children aged 1 mo to 12 y brought dead between July 2024 and June 2025. Fifty-two cases were analyzed. Infants constituted 42.3%, and respiratory illnesses were the leading causes of death (57.7%). Although 94.2% of caregivers sought prior medical care, only 42.3% used ambulance services, and nearly half of the children received no pre-referral treatment. Delay in care was identified in 11.5% of cases, often related to caregiver decision-making. Chronic illness was significantly associated with both cause of death and delay in care. These findings highlight cumulative delays across the continuum of care. Strengthening early illness recognition, referral systems, and pre-hospital emergency services is essential to reduce preventable pediatric mortality.