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Updated: Aug 22, 2025

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Characteristics and Outcomes of Sepsis Presenting in Inpatient Pediatric Settings

Melissa Schafer1, Heidi Gruhler De Souza2, Raina Paul3

  • 1Upstate Golisano Children's Hospital, State University of New York Upstate College of Medicine, Syracuse, New York.

Hospital Pediatrics
|November 8, 2022
PubMed

Insights

Inpatient pediatric sepsis cases show higher mortality and longer hospital stays than emergency department cases. Improving sepsis bundle adherence is linked to better outcomes for hospitalized children.

Area of Science:

  • Pediatric critical care medicine
  • Hospital-acquired infections
  • Sepsis research

Background:

  • Sepsis is a leading cause of death in children's hospitals, yet research on inpatient sepsis is limited.
  • Understanding sepsis in hospitalized children is crucial for improving outcomes.
  • This study addresses the knowledge gap regarding inpatient pediatric sepsis.

Purpose of the Study:

  • To describe the clinical characteristics, process measures, and outcomes of inpatient pediatric sepsis.
  • To compare inpatient sepsis cases with emergency department (ED) sepsis cases.
  • To identify factors influencing morbidity and mortality in pediatric sepsis.

Main Methods:

  • Retrospective cohort study using the Improving Pediatric Sepsis Outcomes registry (January 2017-December 2019).
  • Included 26,855 sepsis cases with onset in inpatient or ED settings.
  • Descriptive statistics were used to compare inpatient and ED sepsis metrics and outcomes.

Main Results:

  • Inpatient sepsis cases (8.4% of cohort) had higher sepsis-attributable mortality (2.0% vs 1.4%) and longer lengths of stay (9 vs 5 days) than ED cases.
  • Inpatient cases required more intensive care admissions (57.6% vs 54.1%) and greater vasopressor use (18.0% vs 13.6%).
  • Improved adherence to sepsis treatment bundles correlated with reduced 30-day sepsis-attributable mortality in inpatients.

Conclusions:

  • Inpatient pediatric sepsis is associated with worse outcomes, including increased mortality, longer hospital stays, and higher intensive care needs, compared to ED sepsis.
  • Timely recognition and adherence to sepsis treatment bundles are critical for improving outcomes in hospitalized children with sepsis.
  • Further research and interventions targeting inpatient sepsis are warranted.
Abstract

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