Resource Use and Outcomes for Children Hospitalized With Severe Sepsis or Septic Shock

Abstract

Objective: To describe patient and hospital characteristics associated with in-hospital mortality, length of stay (LOS), and charges for children with severe sepsis or septic shock who often require specialized organ-supportive technology to enhance outcomes, availability of which might vary across hospitals. Design: Retrospective study among children hospitalized for severe sepsis or septic shock, using the 2012 Kids’ Inpatient Database. Multivariate regression methods identified factors associated with mortality, LOS, and charges. Measurements and Main Results: Of an estimated 11 972 hospitalizations for pediatric severe sepsis or septic shock, most hospitalizations (85%) were to urban teaching hospitals. Hospitalizations were more frequent among neonates and older adolescents than other age groups. Mortality was 17%, average LOS was 24 days, and average hospital charges were US$314 950. Higher mortality was associated with neonates, cumulative organ dysfunction, more comorbidities, and cardiopulmonary resuscitation. Longer hospitalization and higher charges were associated with neonates, more comorbidities, higher illness severity, invasive medical technology, and urban hospitals. Conclusions: Efforts to mitigate the substantial in-hospital mortality and resource use observed in pediatric severe sepsis or septic shock should be age-specific and focused on the influence of comorbidities and organ dysfunction on outcomes. Future research should elucidate reasons for higher resource use at urban hospitals.

The guiding value of inferior vena cava diameter, inferior vena cava collapse index and inferior vena cava to abdominal aorta ratio in neonates with early onset septic shock

“…The mortality rate of neonatal septic shock is as high as 34% [10], requiring prompt recognition and targeted hemodynamic resuscitation [11]. Only clinical evaluation is not accurate [12,13].…”

Effects of surgical treatment on 24465 patients with intestinal perforation complicated with septic shock in tertiary hospitals in China from 2017 to 2020: a systematic review

“…Due to the complex and critical condition of intestinal perforation complicated with septic shock, the treatment is extremely di cult and costly. Average hospital charges for children hospitalized with severe sepsis or septic shock were $ 314 950 (20). The median charge for a septic shock hospitalization of a large academic hospital was $98,583 in the United States (23).…”

“…Average length of stay for children hospitalized with severe sepsis or septic shock was 24 days (20). The median hospital length of stay for acute colonic perforation patients who received rapid source control laparotomy was 20 days (21).…”