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@article{1300372,
author = {Weiss, Scott L. and Fitzgerald, Julie C. and Pappachan, John and Wheeler, Derek and JaramilloandBustamante, Juan C. and Salloo, Asma and Singhi, Sunit C. and Erickson, Simon and Roy, Jason A. and Bush, Jenny L. and Nadkarni, Vinay M. and Thomas, Neal J. and Žurek, Jiří},
article_location = {New York},
article_number = {10},
doi = {http://dx.doi.org/10.1164/rccm.201412-2323OC},
keywords = {multiple organ failure; sepsis; pediatrics},
language = {eng},
issn = {1073-449X},
journal = {AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE},
title = {Global Epidemiology of Pediatric Severe Sepsis: The Sepsis Prevalence, Outcomes, and Therapies Study},
url = {http://dx.doi.org/10.1164/rccm.201412-2323OC},
volume = {191},
year = {2015}
}
TY - JOUR
ID - 1300372
AU - 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. - Žurek, Jiří
PY - 2015
TI - Global Epidemiology of Pediatric Severe Sepsis: The Sepsis Prevalence, Outcomes, and Therapies Study
JF - AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
VL - 191
IS - 10
SP - 1147-1157
EP - 1147-1157
PB - AMER THORACIC SOC
SN - 1073449X
KW - multiple organ failure
KW - sepsis
KW - pediatrics
UR - http://dx.doi.org/10.1164/rccm.201412-2323OC
L2 - http://dx.doi.org/10.1164/rccm.201412-2323OC
N2 - 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 resourcelimited 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.
ER -
WEISS, Scott L., Julie C. FITZGERALD, John PAPPACHAN, Derek WHEELER, Juan C. JARAMILLO-BUSTAMANTE, Asma SALLOO, Sunit C. SINGHI, Simon ERICKSON, Jason A. ROY, Jenny L. BUSH, Vinay M. NADKARNI and Neal J. THOMAS. Global Epidemiology of Pediatric Severe Sepsis: The Sepsis Prevalence, Outcomes, and Therapies Study. \textit{AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE}. New York: AMER THORACIC SOC, 2015, vol.~191, No~10, p.~1147-1157. ISSN~1073-449X. Available from: https://dx.doi.org/10.1164/rccm.201412-2323OC.
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