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Predicting mortality in pediatric sepsis: A nationwide data analysis using a pediatric sepsis surveillance method.
- Source :
-
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy [J Infect Chemother] 2024 Feb; Vol. 30 (2), pp. 93-97. Date of Electronic Publication: 2023 Nov 17. - Publication Year :
- 2024
-
Abstract
- Introduction: A sepsis surveillance method using electronic health records is increasingly used to describe the epidemiology of adult sepsis. However, its application in pediatric populations has been limited, and real-world epidemiology of pediatric sepsis remains unknown. We aimed to determine whether this surveillance method could identify children with sepsis at high-risk of mortality.<br />Patients and Methods: From a nationwide inpatient database in Japan, we included children who underwent blood culture and received antimicrobials for ≥ 4 days between 2014 and 2021. We stratified these children into those with sepsis or without sepsis by the presence of organ dysfunction. We evaluated the discrimination for in-hospital mortality by the sepsis diagnosis and the number of organ dysfunction.<br />Results: Among 6553 eligible children, in-hospital mortality was 7.2 % in 875 children with sepsis and 0.2 % in 5678 children without sepsis. Sepsis diagnosis discriminated in-hospital mortality with a sensitivity of 0.84 and a specificity of 0.87. The area under the curve for mortality based on the number of organ dysfunction was 0.88 (95 % confidence interval:0.84 to 0.93). In-hospital mortality incrementally increased with the number of organ dysfunction; zero, 0.2 %; one, 3.4 %; two, 12.7 %; three, 20.9 %; four, 33.3 %; and five, 50.0 %.<br />Conclusions: The surveillance method effectively identified children with sepsis with high-risk of mortality and demonstrated strong discrimination of mortality.<br />Competing Interests: Conflict of interests The authors have no competing interests to declare that are relevant to the content of this article.<br /> (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1437-7780
- Volume :
- 30
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 37979776
- Full Text :
- https://doi.org/10.1016/j.jiac.2023.11.016