Global epidemiology of pediatric severe sepsis: The sepsis revalence, outcomes, and therapies study

Weiss, Scott L., Fitzgerald, Julie C., Pappachan, John, Wheeler, Derek, Jaramillo-Bustamante, Juan C., Salloo, Asma, Singhi, Sunit C., Erickson, Simon, Roy, Jason A., Bush, Jenny L., Nadkarni, Vinay M., Thomas, Neal J., Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study Investigators and Coulthard, Mark G. (2015) Global epidemiology of pediatric severe sepsis: The sepsis revalence, outcomes, and therapies study. American Journal of Respiratory and Critical Care Medicine, 191 10: 1147-1157. doi:10.1164/rccm.201412-2323OC


Author Weiss, Scott L.
Fitzgerald, Julie C.
Pappachan, John
Wheeler, Derek
Jaramillo-Bustamante, Juan C.
Salloo, Asma
Singhi, Sunit C.
Erickson, Simon
Roy, Jason A.
Bush, Jenny L.
Nadkarni, Vinay M.
Thomas, Neal J.
Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study Investigators
Coulthard, Mark G.
Title Global epidemiology of pediatric severe sepsis: The sepsis revalence, outcomes, and therapies study
Journal name American Journal of Respiratory and Critical Care Medicine   Check publisher's open access policy
ISSN 1073-449X
1535-4970
Publication date 2015-05-01
Year available 2015
Sub-type Article (original research)
DOI 10.1164/rccm.201412-2323OC
Open Access Status Not yet assessed
Volume 191
Issue 10
Start page 1147
End page 1157
Total pages 11
Place of publication New York, United States
Publisher American Thoracic Society
Language eng
Abstract Rationale: Limited data exist about the international burden of severe sepsis in critically ill children.
Formatted abstract
Rationale: Limited data exist about the international burden of severe sepsis in critically ill children.

Objectives: To characterize the global prevalence, therapies, and outcomes of severe sepsis in pediatric intensive care units to better inform interventional trials.

Methods: A point prevalence study was conducted on 5 days throughout 2013–2014 at 128 sites in 26 countries. Patients younger than 18 years of age with severe sepsis as defined by consensus criteria were included. Outcomes were severe sepsis point prevalence, therapies used, new or progressive multiorgan dysfunction, ventilator- and vasoactive-free days at Day 28, functional status, and mortality.

Measurements and Main Results: Of 6,925 patients screened, 569 had severe sepsis (prevalence, 8.2%; 95% confidence interval, 7.6–8.9%). The patients’ median age was 3.0 (interquartile range [IQR], 0.7–11.0) years. The most frequent sites of infection were respiratory (40%) and bloodstream (19%). Common therapies included mechanical ventilation (74% of patients), vasoactive infusions (55%), and corticosteroids (45%). Hospital mortality was 25% and did not differ by age or between developed and resource-limited countries. Median ventilator-free days were 16 (IQR, 0–25), and vasoactive-free days were 23 (IQR, 12–28). Sixty-seven percent of patients had multiorgan dysfunction at sepsis recognition, with 30% subsequently developing new or progressive multiorgan dysfunction. Among survivors, 17% developed at least moderate disability. Sample sizes needed to detect a 5–10% absolute risk reduction in outcomes within interventional trials are estimated between 165 and 1,437 patients per group.

Conclusions: Pediatric severe sepsis remains a burdensome public health problem, with prevalence, morbidity, and mortality rates similar to those reported in critically ill adult populations. International clinical trials targeting children with severe sepsis are warranted.
Keyword Multiple organ failure
Sepsis
Pediatrics
Intensive-Care-Units
Organ dysfunction
Septic shock
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID K12 HD047349
K23 GM110496
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
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