Epidemiology of Sepsis in US Children and Young Adults
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Author/Creator ORCID
Date
2023-04-20
Type of Work
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Citation of Original Publication
Magill, Shelley S, et al. "Epidemiology of Sepsis in U.S. Children and Young Adults" Open Forum Infectious Diseases, ofad218 (20 April, 2023). https://doi.org/10.1093/ofid/ofad218.
Rights
This work was written as part of one of the author's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.
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Public Domain Mark 1.0
Subjects
Abstract
Background
Most multicenter studies of US pediatric sepsis epidemiology use administrative data or focus on pediatric intensive care units. We conducted a detailed medical record review to describe sepsis epidemiology in children and young adults.
Methods
In a convenience sample of hospitals in 10 states, patients aged 30 days–21 years, discharged during 1 October 2014–30 September 2015, with explicit diagnosis codes for severe sepsis or septic shock, were included. Medical records were reviewed for patients with documentation of sepsis, septic shock, or similar terms. We analyzed overall and age group–specific patient characteristics.
Results
Of 736 patients in 26 hospitals, 442 (60.1%) had underlying conditions. Most patients (613 [83.3%]) had community-onset sepsis, although most community-onset sepsis was healthcare associated (344 [56.1%]). Two hundred forty-one patients (32.7%) had outpatient visits 1–7 days before sepsis hospitalization, of whom 125 (51.9%) received antimicrobials ≤30 days before sepsis hospitalization. Age group–related differences included common underlying conditions (<5 years: prematurity vs 5–12 years: chronic pulmonary disease vs 13–21 years: chronic immunocompromise); medical device presence ≤30 days before sepsis hospitalization (1–4 years: 46.9% vs 30 days–11 months: 23.3%); percentage with hospital-onset sepsis (<5 years: 19.6% vs ≥5 years: 12.0%); and percentage with sepsis-associated pathogens (30 days–11 months: 65.6% vs 13–21 years: 49.3%).
Conclusions
Our data suggest potential opportunities to raise sepsis awareness among outpatient providers to facilitate prevention, early recognition, and intervention in some patients. Consideration of age-specific differences may be important as approaches are developed to improve sepsis prevention, risk prediction, recognition, and management.