Burden of Paediatric Sepsis in a Tertiary Centre from a Developing Country

Abstract

Background: Sepsis causes significant paediatric morbidity and mortality in developing countries. This paper describes the outcome of paediatric sepsis in the University Hospital of the West Indies (UHWI), Jamaica, using administrative data from hospital records from 2010 to 2014. Objective: To provide baseline data on the burden and outcome of paediatric sepsis in a tertiary institution in Jamaica between 2010 and 2014 so as to embark on initiatives to build capacity to provide care in order to decrease the burden and improve the outcomes from sepsis in children. Methods: Data were abstracted from electronic discharge summaries of children hospitalized at the UHWI, a tertiary centre that accepts referrals for newborns and children with complex disorders. The medical records of children aged 0-16 years who were hospitalized with a diagnosis of sepsis, septicaemia and neonatal sepsis were reviewed, using the World Health Organization's International Classification of Diseases, 10 th Revision (ICD-10). Demographic and outcome data were extracted. Results: Among 7011 children aged 0-16 years who were admitted, sepsis accounted for 801 hospitalizations in 782 children with a male to female ratio of 1.27 to 1. Neonates comprised 86% (n = 691), of which 36.2% (n = 250) were preterm. The median duration of hospitalization was 10 days (range: 0-366 days; interquartile range: 7-19 days). The sepsis-attributable mortality rate was 10.1% (n = 70) in neonates and was higher in preterm versus term neonates (18.4%, n = 46/250 versus 6.0%, n = 26/434, respectively). The annual crude mortality rate for paediatric sepsis was 9-11% (12 per 1000 paediatric hospitalizations). Conclusion: Sepsis accounted for a high number of admissions and consumed significant resources as evidenced by the long duration of hospitalization. The mortality rate for paediatric sepsis was high, especially in newborns. Targeted interventions are needed to reduce the sepsis-attributable burden and improve outcomes established by the Global Sepsis Alliance and United Nations' Sustainable Development Goals.