Evidence map›Paper›PMID 40017481›Full record

ArticleJournal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)2025

Association between hospital case volume and mortality in pediatric sepsis: A retrospective observational study using a Japanese nationwide inpatient database.

Shingo Ohki, Makoto Otani, Shinichi Tomioka, Kosaku Komiya, Hideki Kawamura, Taka-Aki Nakada, Satoshi Nakagawa, Shinya Matsuda, Nobuaki Shime

Abstract read
In one paragraph

Article in Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Decisions, outcomes, and learning from what didn't go wrong.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026
    Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Shingo OhkiGraduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Makoto OtaniUniversity of Occupational and Environmental Health, Kitakyushu, Japan.
Shinichi TomiokaGraduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Kosaku KomiyaFaculty of Medicine, Oita University, Oita, Japan.
Hideki KawamuraKagoshima University Hospital, Kagoshima, Japan.
Taka-Aki NakadaGraduate School of Medicine, Chiba University, Chiba, Japan.
Satoshi NakagawaNational Center for Child Health and Development, Tokyo, Japan.
Shinya MatsudaUniversity of Occupational and Environmental Health, Kitakyushu, Japan.
Nobuaki ShimeGraduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: The survival benefits of treatment at high-volume hospitals (HVHs) are well-documented for several critical pediatric conditions. However, their impact on pediatric sepsis, a leading cause of mortality among children, remains understudied. Aim of the study: To investigate the association between hospital case volume and mortality rates in pediatric sepsis. Material and Methods: We conducted a retrospective cohort study using data from the Diagnosis Procedure Combination database. The study included patients who met the following criteria: 1) aged 28 days to 17 years; 2) discharged from the hospital between April 2014 and March 2018; 3) had a sepsis diagnosis coded under the International Classification of Diseases, 10th revision; 4) underwent blood cultures on hospital admission day (day 0) or day 1; 5) received antimicrobial agents on day 0 or 1; and 6) required at least one organ support measure (e.g., mechanical ventilation or vasopressors) on day 0 or 1. Hospitals were categorized by case volume during the study period, with HVHs defined as those in the highest quartile and low-volume hospitals (LVHs) as those in the remaining quartiles. In-hospital mortality rates between HVH and LVH groups were compared using mixed-effects logistic regression analysis with propensity score (PS) matching. Results: A total of 934 pediatric patients were included in the study, with an overall in-hospital mortality rate of 16.1%. Of them, 234 were treated at 5 HVHs (≥26 patients in 4 years), and 700 at 234 LVHs (<26 patients in 4 years). Upon PS matching, patients treated at HVHs demonstrated significantly lower odds of in-hospital mortality compared with those treated at LVHs (odds ratio, 0.42; 95% confidence interval, 0.22-0.80; P = 0.008). Conclusions: In pediatric patients with sepsis, treatment at HVHs was associated with lower odds of in-hospital mortality.

Indexed as

hospital case volumepediatricspropensity scoresepsisvolume-outcome relationship

Identifiers

PMID40017481
PMCPMC11864061

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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.