Long-Term Mortality and Morbidity After Pediatric Sepsis

Adults experience sustained disease burden in the years following sepsis, but data regarding long-term prognosis after pediatric sepsis are still limited. The objective of this study was to determine long-term outcomes after sepsis in children, in terms of mortality, morbidity, and socioeconomic factors.

This cohort study was based on a nationwide historical cohort of 55 906 pediatric sepsis hospitalizations, as compared with a control cohort of 93 274 pediatric nonsepsis hospitalizations with organ dysfunction, with linked register data on patient characteristics. Exposure was defined as sepsis hospitalization before 18 years of age. Cox regression was used to estimate hazard ratios for long-term mortality, with adjustments for age and comorbidities. Logistic regression was used to compare the prevalence of diseases in the groups during follow-up. Socioeconomic outcome in terms of education level, unemployment, and disability pension was compared with logistic regression at 20, 25, and 30 years of age. The study was set in Sweden, 1 January 1987 to 31 December 2022.

During the first 5 years of follow-up, the sepsis cohort had higher mortality, with a hazard ratio of 1.17 (95% CI, 1.11-1.22), adjusted for age and comorbidities. Subsequent sepsis, infectious disease, and respiratory disease during the follow-up were more common in the sepsis cohort than in the control cohort.

The findings of this study call for increased attention of health care to survivors of pediatric sepsis and enhanced follow-up.