Evidence map›Paper›PMID 25162514›Full record

ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2014

Pediatric severe sepsis in U.S. children's hospitals.

Fran Balamuth, Scott L Weiss, Mark I Neuman, Halden Scott, Patrick W Brady, Raina Paul, Reid W D Farris, Richard McClead, Katie Hayes, David Gaieski and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 146 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
146citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

146 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Guideline
  6. Trial
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Observational
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review

86 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Fran Balamuth1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 2Division of Emergency Medicine and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA. 3Department of Anesthesia and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 4Division of Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA. 5Department of Pediatrics, Harvard Medical School, Boston, MA. 6Division of Emergency Medicine, Boston Children's Hospital, Boston, MA. 7Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO. 8Section of Emergency Medicine, Children's Hospital Colorado, Aurora, CO. 9Division of Hospitalist Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 10Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 11Division of Emergency Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC. 12Department of Pediatrics, University of Washington, Seattle, WA. 13Division of Critical Care Medicine, Children's Hospital Seattle, Seattle, WA. 14Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH. 15Nationwide Children's Hospital, Columbus, OH. 16Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 17Department of Analytics, Children's Hospital Association, Washington, DC. 18Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 19Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL. 20Division of Emergency Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Scott L Weiss
Mark I Neuman
Halden Scott
Patrick W Brady
Raina Paul
Reid W D Farris
Richard McClead
Katie Hayes
David Gaieski
Matt Hall
Samir S Shah
Elizabeth R Alpern

Funding

Pediatric Critical Care Scientist Development ProgramK12HD047349 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI HEATHER T. KEENAN, Kevin M Watt · 2004 to 2026
$17.0M
Pursuing Perfection in Pediatric TheraputicsU19HS021114 · AHRQ · CINCINNATI CHILDRENS HOSP MED CTR · PI LANNON, CAROLE MARIE · 2011 to 2015
$4.2M
Enabling Medical Research Growth in Emergency MedicineK12HL109009 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KIMMEL, STEPHEN E. · 2011 to 2015
$3.4M
Mitochondrial Dysfunction in Pediatric SepsisK23GM110496 · NIGMS · CHILDREN'S HOSP OF PHILADELPHIA · PI WEISS, SCOTT L · 2015 to 2018
$723k
AHRQ HHS U19HS021114NHLBI NIH HHS K12 HL109009NICHD NIH HHS K12 HD047349NICHD NIH HHS K12HD047349NIGMS NIH HHS K23 GM110496
6 · The paper itself

Abstract

objectivesTo compare the prevalence, resource utilization, and mortality for pediatric severe sepsis identified using two established identification strategies.

designObservational cohort study from 2004 to 2012.

settingForty-four pediatric hospitals contributing data to the Pediatric Health Information Systems database. PATIENTS: Children 18 years old or younger. MEASUREMENTS AND MAIN

resultsWe identified patients with severe sepsis or septic shock by using two International Classification of Diseases, 9th edition, Clinical Modification-based coding strategies: 1) combinations of International Classification of Diseases, 9th edition, Clinical Modification codes for infection plus organ dysfunction (combination code cohort); 2) International Classification of Diseases, 9th edition, Clinical Modification codes for severe sepsis and septic shock (sepsis code cohort). Outcomes included prevalence of severe sepsis, as well as hospital and ICU length of stay, and mortality. Outcomes were compared between the two cohorts examining aggregate differences over the study period and trends over time. The combination code cohort identified 176,124 hospitalizations (3.1% of all hospitalizations), whereas the sepsis code cohort identified 25,236 hospitalizations (0.45%), a seven-fold difference. Between 2004 and 2012, the prevalence of sepsis increased from 3.7% to 4.4% using the combination code cohort and from 0.4% to 0.7% using the sepsis code cohort (p < 0.001 for trend in each cohort). Length of stay (hospital and ICU) and costs decreased in both cohorts over the study period (p < 0.001). Overall, hospital mortality was higher in the sepsis code cohort than the combination code cohort (21.2% [95% CI, 20.7-21.8] vs 8.2% [95% CI, 8.0-8.3]). Over the 9-year study period, there was an absolute reduction in mortality of 10.9% (p < 0.001) in the sepsis code cohort and 3.8% (p < 0.001) in the combination code cohort.

conclusionsPrevalence of pediatric severe sepsis increased in the studied U.S. children's hospitals over the past 9 years, whereas resource utilization and mortality decreased. Epidemiologic estimates of pediatric severe sepsis varied up to seven-fold depending on the strategy used for case ascertainment.

Indexed as

AdolescentChildChild, PreschoolCohort StudiesFemaleHospital MortalityHospitals, PediatricHumansInfantInfant, NewbornIntensive Care Units, PediatricInternational Classification of DiseasesLength of StayMalePrevalenceRetrospective Studies

Identifiers

PMID25162514
PMCPMC4221502

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.