The Rate of Sepsis in a National Pediatric Population, 2006 to 2012

Schuller, Kristin; Hsu, Benson; Thompson, Allyson B

doi:10.1177/0009922817702940

Cited by 12 publications

(4 citation statements)

References 30 publications

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“…From the perspective of disease incidence, neonates are a special group, and they are more likely to develop into sepsis [ 53 ]. Studies have demonstrated that the incidence of severe sepsis in children increased from 92.8 cases per 100,000 to 158.7 cases per 100,000 over the past decade [ 54 , 55 ], whereas the incidence among adults has remained nearly constant over recent decades [ 56 ]. In addition, the most significant differences between adults and neonatal sepsis are observed in outcomes [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of IVIG therapy for patients with sepsis: a systematic review and meta-analysis

Pan,

Sun,

Pei

et al. 2023

J Transl Med

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Background Sepsis is an overwhelming reaction to infection that comes with high morbidity and mortality. It requires urgent interventions in order to improve outcomes. Intravenous immunoglobulins (IVIG) are considered as potential therapy in sepsis patients. Results of trials on IVIG as adjunctive therapy for sepsis have been conflicting due to the variability in population characteristics, country geography and drug dosage form in different studies. Methods A systematic article search was performed for eligible studies published up to January, 31, 2023, through the PubMed, Embase, Cochrane Library and Chinese National Knowledge Infrastructure database. The included articles were screened by using rigorous inclusion and exclusion criteria. Subgroup analyses were conducted according to different IVIG types, ages and economic regions. All analyses were conducted using Review Manager 5.4. Quality of studies and risk of bias were evaluated. Results In total, 31 randomized controlled trials were included with a sample size of 6,276 participants. IVIG could reduce the mortality (RR 0.86, 95% CI: 0.77–0.95, p = 0.005), the hospital stay (MD − 4.46, 95% CI: − 6.35 to − 2.57, p = 0.00001), and the APACHE II scores (MD − 1.65, 95% CI: − 2.89 to − 0.63, p = 0.001). Additionally, the results showed that IgM-enriched IVIG was effective in treating sepsis (RR 0.55, 95% CI: 0.40 − 0.76; p = 0.0003), while standard IVIG failed to be effective (RR 0.91, 95% CI: 0.81–1.02, p = 0.10). And the effect of IVIG in reducing neonatal mortality was inconclusive (RR 0.93, 95% CI: 0.81–1.05, p = 0.24), but it played a large role in reducing sepsis mortality in adults (RR 0.70, 95% CI: 0.57–0.86, p = 0.0006). Besides, from the subgroup of different economic regions, it indicated that IVIG was effective for sepsis in high-income (RR 0.89, 95% CI: 0.79–0.99, p = 0.03) and middle-income countries (RR 0.49, 95% CI: 0.28–0.84, p = 0.01), while no benefit was demonstrated in low-income countries (RR 0.56, 95% CI: 0.27–1.14, p = 0.11). Conclusions There is sufficient evidence to support that IVIG reduces sepsis mortality. IgM-enriched IVIG is effective in both adult and neonatal sepsis, while standard IVIG is only effective in adult sepsis. IVIG for sepsis has shown efficacy in high- and middle-income countries, but is still debatable in low-income countries. More RCTs are needed in the future to confirm the true clinical potential of IVIG for sepsis in low-income countries.

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Section: Discussionmentioning

confidence: 99%

Efficacy of IVIG therapy for patients with sepsis: a systematic review and meta-analysis

Pan,

Sun,

Pei

et al. 2023

J Transl Med

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“…Among the pediatric population in the United States, 50,000 cases of severe sepsis occur annually, a number that has been on the rise for a condition that carries a mortality rate of approximately 10% [ 1 ]. In 1992, the Society of Critical Care Medicine designated a band cell concentration of more than 10% of the total peripheral white blood cell (WBC) count as one of the criteria for systemic inflammatory response syndrome [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Severe Bandemia Is Not Associated With Increased Risk for Adverse Events in General Pediatric Emergency Department Patients

Najafali¹,

Kaur²,

Afridi³

et al. 2021

Cureus

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Introduction: The presence of band cells > 10% of the total white blood cell (WBC) count (“bandemia”) is often used as an indicator of serious bacterial illness (SBI). Results from studies of bandemia as a predictor of SBI were conflicting and little is known about the relationship between severe bandemia (SB) and clinical outcomes from SBI in children. We hypothesized that SB (band level > 20%) is not associated with adverse outcomes in an emergency department (ED) pediatric population. Methods: Medical records from children between the ages of two months and 18 years with SB who presented to a tertiary referral regional hospital were studied. Outcomes were categorized as severe adverse events (SAEs) or moderate adverse events (MAEs). Multivariate logistic regressions were used to assess the association between SB and outcomes. Results: We analyzed 102 patients. Mean age (standard deviation, SD) was 5.25 (0.5) years, 18 (18%) had MAE, 21 (21%) had SAE, and no patients died. Mean band levels were similar between groups: no adverse events 28 (10) vs. SAE 31 (9) vs. MAE 27 (8), p=0.64. Multivariate logistic regressions showed SB was not associated with any adverse events (odds ratio (OR) 1.04, 95% confidence interval (CI) 0.9-1.1, p=0.27). Non-normal X-ray (XR) (OR 17, 95% CI 3.3-90, p<0.001) was associated with MAE, while non-normal computerized tomography (CT) scan (OR 15.4, 95% CI 2.2-100+, p=0.002) was associated with SAE. Conclusion: SB was not associated with higher odds of adverse events among the general ED pediatric population. Clinicians should base their clinical judgment on the overall context of history, physical examinations, and other laboratory and imaging data.

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“…Sepsis is a major cause of death and morbidity in the United States and throughout the world. It is estimated to occur among children in the US at a rate of 158.7 cases per 100,000 children [1]. Of these, over one third requires hospitalization with total healthcare costs exceeding 14 billion dollars annually [2].…”

Section: Introductionmentioning

confidence: 99%

Interventions for Pediatric Sepsis and Their Impact on Outcomes: A Brief Review

Watkins

2018

Healthcare

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In the current era, pediatric sepsis remains a public health problem of significant prevalence and impact. With mortality rates practically unchanged over the years, this review hopes to briefly summarize the epidemiology and the current interventions for pediatric sepsis and point towards possible areas of improvement. Most pediatric studies of sepsis are either small, retrospective or observational. Given information technology spreading across country, and a stronger presence of clinical networks, development of multicenter prospective studies over the next decade should enable better treatments for pediatric sepsis, and improved outcomes.

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The Rate of Sepsis in a National Pediatric Population, 2006 to 2012

Abstract: This study helps clarify the population demographics that are at greater risk for sepsis infections. Understanding the at-risk population aids policymakers and care providers in targeting these populations and make drastic changes to sepsis policies.

Cited by 12 publications

References 30 publications

Efficacy of IVIG therapy for patients with sepsis: a systematic review and meta-analysis

Efficacy of IVIG therapy for patients with sepsis: a systematic review and meta-analysis

Severe Bandemia Is Not Associated With Increased Risk for Adverse Events in General Pediatric Emergency Department Patients

Interventions for Pediatric Sepsis and Their Impact on Outcomes: A Brief Review

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