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Trend and outcome of sepsis in children: A nationwide cohort study
Author(s) -
Yo ChiaHung,
Hsu TzuChun,
Gabriel Lee MengTse,
Porta Lorenzo,
Tsou PoYang,
Wang YuHsun,
Lee WanChien,
Chen SzuTa,
Lee ChienChang
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13849
Subject(s) - medicine , sepsis , incidence (geometry) , pediatrics , population , respiratory tract infections , cohort , septic shock , cohort study , respiratory system , physics , environmental health , optics
Aim The aim of this study was to investigate the trend of incidence and outcome of paediatric sepsis in a population‐based database. Methods Children with sepsis were identified from the 23 million nationwide health insurance claims database of Taiwan. Sepsis was defined by the presence of single ICD‐9 code for severe sepsis or septic shock or a combination of ICD‐9 codes for infection and organ dysfunction. We analysed the trend of incidence, mortality and source of infection in three age groups: infant (28 days to 1 year), child (1–9 years) and adolescent (10–18 years). Results From 2002 to 2012, we identified 38 582 paediatric patients with sepsis, of which 21.3% were infants, 52.8% were children and 25.8% were adolescents. The incidence of sepsis was 336.4 cases per 100 000 population in infants, 3.3 times higher than in children (101.5/100 000 cases) and 7.3 times higher than in adolescents (46.2/100 000 cases). While sepsis incidence decreased from 598.0 to 336.4 cases per 100 000 people in the infant population, it remained relatively unchanged in children and adolescents. For 90‐day mortality, there were significant decreases in all three age groups (absolute decrease of 5.0% for infants, 3.7% for children and 14.4% for the adolescents). In the infant population, we observed a decrease in the incidence of lower respiratory tract infections, while the incidence of urinary tract infections remained unchanged. Conclusions The incidence and mortality of sepsis among paediatric patients have decreased substantially between 2002 and 2012, especially among infants. The widespread use of Haemophilus influenzae and pneumococcal vaccines in infants could be a possible explanation.