ArticlePloS one2014
Why children with severe bacterial infection die: a population-based study of determinants and consequences of suboptimal care with a special emphasis on methodological issues.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Role of Parental Concerns in the Recognition of Sepsis in Children: A Literature Review.Frontiers in pediatrics · 2019Pooled it
- Interventions to increase the use of electronic health information by healthcare practitioners to improve clinical practice and patient outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- International survey on immunological diagnostics in children with sepsis.Intensive care medicine. Paediatric and neonatal · 2026Article
- Factors associated with severe bacterial infection in infants between 91- and 120-days old admitted to the pediatric emergency department.BMC pediatrics · 2025Article
- Identifying barriers and facilitators to seeking care for symptoms of bacterial sepsis: A qualitative study.Nursing open · 2023Article
- Alternative Antimicrobial Irrigation Strategies for the Treatment of Infections in Children: A Review of the Existing Literature.Antibiotics (Basel, Switzerland) · 2023Review
- Exploration of pre-hospital patient delays in seeking care for symptoms of bacteremia and sepsis: A qualitative study.Nursing open · 2023Article
- Swiss Sepsis National Action Plan: A coordinated national action plan to stop sepsis-related preventable deaths and to improve the support of people affected by sepsis in Switzerland.Frontiers in medicine · 2023Article
- Impact of parental and healthcare professional concern on the diagnosis of pediatric sepsis: a diagnostic accuracy study.Frontiers in pediatrics · 2023Article
- Prevalence, Characteristics, and Determinants of Suboptimal Care in the Initial Management of Community-Onset Severe Bacterial Infections in Children.JAMA network open · 2022Article
- Pediatric Sepsis in Community Emergency Care Settings: Guideline Concordance and Outcomes.Pediatric emergency care · 2021Article
- Article
- Article
- Defining benefit threshold for extracorporeal membrane oxygenation in children with sepsis-a binational multicenter cohort study.Critical care (London, England) · 2019Article
- Prediction of pediatric sepsis mortality within 1 h of intensive care admission.Intensive care medicine · 2017Article
- Observational
- Impact of a Multidisciplinary Sepsis Initiative on Knowledge and Behavior in a Pediatric Center.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSuboptimal care is frequent in the management of severe bacterial infection. We aimed to evaluate the consequences of suboptimal care in the early management of severe bacterial infection in children and study the determinants.
methodsA previously reported population-based confidential enquiry included all children (3 months- 16 years) who died of severe bacterial infection in a French area during a 7-year period. Here, we compared the optimality of the management of these cases to that of pediatric patients who survived a severe bacterial infection during the same period for 6 types of care: seeking medical care by parents, evaluation of sepsis signs and detection of severe disease by a physician, timing and dosage of antibiotic therapy, and timing and dosage of saline bolus. Two independent experts blinded to outcome and final diagnosis evaluated the optimality of these care types. The effect of suboptimal care on survival was analyzed by a logistic regression adjusted on confounding factors identified by a causal diagram. Determinants of suboptimal care were analyzed by multivariate multilevel logistic regression.
resultsSuboptimal care was significantly more frequent during early management of the 21 children who died as compared with the 93 survivors: 24% vs 13% (p = 0.003). The most frequent suboptimal care types were delay to seek medical care (20%), under-evaluation of severity by the physician (20%) and delayed antibiotic therapy (24%). Young age (under 1 year) was independently associated with higher risk of suboptimal care, whereas being under the care of a paediatric emergency specialist or a mobile medical unit as compared with a general practitioner was associated with reduced risk.
conclusionsSuboptimal care in the early management of severe bacterial infection had a global independent negative effect on survival. Suboptimal care may be avoided by better training of primary care physicians in the specifics of pediatric medicine.
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