Epidemiology of Pediatric Septic Shock

Abstract

Sepsis, or dysregulated host response to infection, is considered a worldwide public health problem. It is a major childhood disease both in terms of frequency and severity, and severe sepsis is still considered the main cause of death from infection in childhood. This review provides an overview of the epidemiology of pediatric septic shock. The prevalence of severe sepsis and septic shock among hospitalized children ranges from 1 to 26%. Mortality is high, ranging from 5% in developed countries to up to 35% in developing countries. However, 10 years after the publication of pediatric sepsis definitions, a global perspective on the burden of this disease in childhood is still missing. Major obstacles to a better knowledge of sepsis epidemiology in children are the absence of an adequate disease definition and not having sepsis as a cause of death in the World Health Organization Global Burden of Disease Report, which is one of the most important sources of information for health policies decision-making in the world. Several studies performed in both developed and developing countries have shown that mortality from septic shock is high and is associated with delayed diagnosis, late treatment, and nonadherence to the treatment guidelines. Reducing mortality from sepsis in childhood is a worldwide challenge, especially in developing countries, where the highest number of cases and deaths are recorded and where financial resources are scarce. Many specialists consider that prevention, education, and organization are key to achieve a reduction in the burden of sepsis.

Admission platelet count and indices as predictors of outcome in children with severe Sepsis: a prospective hospital-based study

“…The prevalence of severe sepsis and septic shock among hospitalized children ranges from 1 to 26%. Mortality is high, ranging from 5% in developed countries reaching up to 35% in developing countries [1].…”

“…Many studies performed in both developing and developed countries have shown that mortality from sepsis is high and is associated with delayed diagnosis, late treatment, and nonadherence to the treatment guidelines. Reducing mortality from pediatric sepsis is a worldwide challenge [1].…”

Modern Diagnostics of Sepsis and Septic Shock in Children

“…In developing countries, the incidence of severe sepsis among children also varied from 1% to 25.9%, and the mortality rate was 12.3-34.6%. The authors attribute these significant fluctuations to various diagnostic criteria and economic factors (16,17).…”

Clinical outcome of children with fluid-refractory septic shock treated with dopamine or epinephrine. A retrospective study at a pediatric emergency department in Argentina

“…Sepsis is a global health threat. ( 1 - 7 ) Although the actual impact of sepsis is difficult to determine (due to a lack of adequate definitions and inadequate registration of the entity as a cause of death in global reports), it is considered to be the worldwide leading cause of death in childhood ( 7 ) accounting for up to 60% of deaths in children under 5 years of age. ( 2 - 6 ) In Argentina, few epidemiological data on sepsis in children are available; however, it has been estimated that sepsis represents one of the main causes of death in this population.…”