other Emergency Medicine Emergency Medicine Meta-analysis Article <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">Emergency departments with high readiness to admit children may reduce mortality rates, but comprehensive and comparative evidence is limited. This study is the first systematic review and meta-analysis conducted to determine the effect of pediatric emergency department readiness on in-hospital mortality.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> A search for relevant articles was conducted up to 17 December 2025 in the international databases PubMed, EMBASE, Scopus, and Web of Science. Relevant keywords were used for the search. Current study question: In children presenting to emergency departments (Population), how is the level of emergency readiness for pediatric care (Exposure) associated with mortality (Outcome)? This section was created using the PICO approach. Data analyses were conducted using the meta-analysis packages in STATA/MP.v17 (College Station, Texas, USA).</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Results:</b> The overall in-hospital mortality rate was estimated to be about 2%. Meta-analysis showed that care at highest-readiness EDs (Quartile 4 wPRS) was associated with a significant reduction in mortality (OR=0.617; 95% CI, 0.491&ndash;0.744).</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Conclusion: </b>Increasing the level of emergency department pediatric readiness can be associated with a reduction in in-hospital mortality. These findings highlight the importance of policy to improve standards of pediatric emergency readiness in all hospitals.</span></span></span></span></span></span></span></span><br> &nbsp; Pediatric Emergency Department, in-hospital mortality, Readiness, Children 554 561 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-1131&slc_lang=other&sid=1 Seyed Mohammad Hosseini Kasnavieh mhoseini1346@gmail.com 200319475328460098336 200319475328460098336 No Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Maryam Milanifard maryammilani837@yahoo.com 200319475328460098337 200319475328460098337 No Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Mohsen Sedighi sedighi.mo@iums.ac.ir 200319475328460098338 200319475328460098338 No Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran Roxana Hessam hessamroxana@yahoo.com 200319475328460098339 200319475328460098339 Yes Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran