Original ArticlesChildren with Chronic Disease Bear the Highest Burden of Pediatric Sepsis
Section snippets
Methods
We used a retrospective cohort design and the Nationwide Readmissions Database (NRD)10 from 2013, which includes 49% of all hospital admissions in the US. The NRD includes hospitalizations for children who were between 1 and 18 years of age from 21 states and hospitalizations for children <1 year of age from 9 states. This study was deemed exempt by the University of Pittsburgh Institutional Review Board.
We estimated the national incidence of sepsis using the weights provided by the NRD and
Results
Of the 14 325 172 admissions in the NRD, 1 227 931 admissions were in patients <19 years of age, of which 309 675 (25.2%) were neonatal patients admitted. Of the 918 256 non-neonatal pediatric admissions, 16 387 met the criteria for sepsis. The estimated national incidence in the pediatric population was 0.72 per 1000, with an estimated 54 060 cases per year (Figure 1).
Discussion
In a nationally representative cohort of pediatric patients with sepsis, we showed that the proportion with a chronic disease has increased compared with prior studies,1, 2, 15 and >68% of admissions now have ≥1 chronic disease. We also found that patients with severe sepsis and septic shock or sepsis with identified organ dysfunction had a higher prevalence of chronic disease than those with sepsis without identified organ dysfunction. This finding underscores the continued national shift in
Data Statement
Data will be made available on request.
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Cited by (0)
Supported by the National Institute of General Medical Sciences (R01GM097471 and R34GM107650) and the National Institutes of Health (R35GM119519). The authors declare no conflicts of interest.
Portions of this study were presented at the 46th Critical Care Congress, January 21-25, 2017, Honolulu, Hawaii.