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Pediatric sepsis survival in pediatric and general emergency departments

Alexandra H Baker1, Michael C Monuteaux2, Matthew A Eisenberg1

  • 1Division of Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.

The American Journal of Emergency Medicine
|October 21, 2021
PubMed

Insights

Pediatric sepsis mortality is lower in specialized pediatric emergency departments (EDs) compared to general EDs. Identifying key features of pediatric ED care can improve survival rates for children with sepsis.

Area of Science:

  • Pediatric Emergency Medicine
  • Critical Care
  • Public Health

Background:

  • Sepsis is a life-threatening condition requiring timely and appropriate care.
  • Understanding variations in sepsis outcomes between different emergency department (ED) settings is crucial for improving pediatric patient survival.
  • Differences in mortality rates for pediatric sepsis between specialized pediatric EDs and general EDs are not well-defined.

Purpose of the Study:

  • To determine if pediatric sepsis mortality rates differ significantly between pediatric emergency departments and general emergency departments.
  • To identify potential factors contributing to variations in sepsis outcomes for pediatric patients.

Main Methods:

  • A retrospective cohort study was conducted using the 2008-2017 Nationwide Emergency Department Sample (NEDS).
  • The study included pediatric patients (under 19 years) diagnosed with severe sepsis or septic shock.
  • Logistic regression was used to compare ED and hospital mortality between pediatric and general EDs, controlling for relevant covariates.

Main Results:

  • A total of 54,129 weighted pediatric ED visits for severe sepsis or septic shock were analyzed.
  • Mortality risk prior to ED disposition was lower in pediatric EDs (0.31%) versus general EDs (0.72%).
  • Hospital mortality risk was also lower in pediatric EDs (7.5%) compared to general EDs (10.9%).

Conclusions:

  • Pediatric patients with severe sepsis or septic shock experienced lower mortality rates in pediatric EDs compared to general EDs.
  • These findings highlight the importance of specialized pediatric care in sepsis management.
  • Further research into the specific elements of pediatric ED care associated with improved sepsis survival is warranted.
Abstract

Keywords:
Pediatric SepsisPediatric readinessSepsisSepsis mortality

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