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Children with Chronic Disease Bear the Highest Burden of Pediatric Sepsis

Andrew J Prout1, Victor B Talisa2, Joseph A Carcillo3

  • 1The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.

The Journal of Pediatrics
|May 14, 2018
PubMed

Insights

Pediatric sepsis disproportionately affects children with chronic diseases, leading to significantly higher in-hospital mortality. These chronic conditions are a major contributor to sepsis-related deaths in hospitalized children.

Area of Science:

  • Pediatric critical care medicine
  • Epidemiology of infectious diseases
  • Public health research

Background:

  • Pediatric sepsis is a life-threatening condition.
  • Children with chronic diseases are at higher risk for severe sepsis outcomes.
  • Understanding the epidemiology of pediatric sepsis in vulnerable populations is crucial.

Purpose of the Study:

  • To determine the current epidemiology of pediatric sepsis in children with chronic diseases.
  • To assess the impact of chronic diseases on sepsis-related mortality in children.
  • To describe the national incidence and mortality rates of pediatric sepsis.

Main Methods:

  • Retrospective cohort analysis of the 2013 Nationwide Readmissions Database.
  • Inclusion of non-neonatal patients (<19 years) hospitalized with sepsis.
  • Use of mixed effects logistic regression to analyze the association between chronic diseases and mortality.

Main Results:

  • The national incidence of pediatric sepsis was 0.72 per 1000 person-years (54,060 cases annually).
  • Over two-thirds (68.6%) of sepsis admissions involved children with at least one chronic disease.
  • In-hospital mortality was 5.1% for children with chronic disease versus 0.7% for previously healthy children.

Conclusions:

  • The majority of pediatric sepsis cases occur in children with chronic diseases.
  • Chronic diseases significantly increase the risk of in-hospital mortality for children with sepsis.
  • Pediatric patients with chronic conditions bear the greatest burden of sepsis.
Abstract

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