Background. Severe anaemia (haemoglobin concentration <50 g/l) is amajor cause of paediatric hospital admissions and deaths in the tropics.Objectives.To examine the pattern and predictors of mortalityamong severely anaemic children.Methods. A prospective cross-sectional study was conducted among children with severe anaemia at the Children’s Emergency Room of the University Teaching Hospital, Ado-Ekiti, Nigeria. Sociodemographiccharacteristics, clinical features, laboratory findings and co-morbidities of the survivors and those who died were compared by logistic regression analysis.Results. Of the 1 735 children admitted, 311 (17.9%) had severeanaemia, with a case-fatality rate of 9.3%. The presence of respiratorydistress (95% confidence interval (CI) 2.1 - 3.6, p=0.031); acidosis(95% CI 1.8 - 2.7, p=0.010); coma (95% CI 0.1 - 0.3, p=0.001);hypotension (95% CI 2.0 - 4.2, p=0.020); and bacteraemia (95% CI 3.1- 3.9; p=0.008) were the significant independent predictors of deathwith regression analysis.Conclusion. Early recognition with prompt and appropriate anticipatory intervention is essential to reduce mortality from severe anaemia
