Evidence map›Paper›PMID 41648052›Full record

ArticleFrontiers in pediatrics2025

Pediatric severe sepsis: epidemiology and risk factors associated with acute kidney injury.

Haibo Li, Ying Zhang, Hongyan Zhu, Ran Yu, Qi Zhou, Jiannan Song, Jiannan Wu, Wanli Ma, Zhanfei Hu, Jian Wang and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

12 authors.

Haibo Li *Department of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng Municipal Hospital, Chifeng, China.
Ying Zhang *Department of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.
Hongyan Zhu *Department of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng Municipal Hospital, Chifeng, China.
Ran YuDepartment of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng, China.
Qi ZhouDepartment of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng Municipal Hospital, Chifeng, China.
Jiannan SongDepartment of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng Municipal Hospital, Chifeng, China.
Jiannan WuDepartment of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng Municipal Hospital, Chifeng, China.
Wanli MaDepartment of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng Municipal Hospital, Chifeng, China.
Zhanfei HuDepartment of Anesthesiology, Affiliated Chifeng Clinical Medical College of Inner Mongolia Medical University, Chifeng Municipal Hospital, Chifeng, China.
Jian WangDivision of Orthopaedic Surgery, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Xuegao YuDepartment of Laboratory Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Hongyu ZhangFive Senses Ward, Nanfang Hospital Zengcheng Campus, Southern Medical University, Guangzhou, Guangdong, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pediatric severe sepsis (PSS) is one of the leading causes of morbidity and mortality in children, incurring substantial social costs. Acute kidney injury (AKI) plays a critical role in determining PSS severity and prognosis. However, existing literature provides limited data regarding the risk factors associated with AKI in pediatric sepsis patients and the impact of AKI on hospital outcomes for these patients. This study aimed to analyze the temporal trends in incidence and outcomes of AKI among hospitalized PSS patients from 2010 to 2019, and identify associated risk factors; and assess the impact of AKI on in-hospital mortality and healthcare resource utilization. Methods: This study utilized the nationally representative National Inpatient Sample (NIS) database of the United States to conduct a retrospective analysis. All children aged 0 (infants) to 18 years who were diagnosed with severe sepsis between 2010 and 2019 were included. Patients were grouped by AKI status, and in-hospital mortality and medical resource utilization (length of stay and inflation-adjusted costs) were compared. Multivariate regression identified AKI risk factors. Results: The incidence rate of AKI among hospitalized PSS patients increased from 2.7% in 2010 to 8.0% in 2019. However, in-hospital mortality declined from 32.40% to 17.90% over the same period. The incidence of AKI was significantly higher in patients with comorbidities. Studies have shown that hospitalizations associated with AKI have a higher likelihood of involving infection sites and a variety of pathogenic flora. Conclusion: While the incidence of AKI increased from 2010 to 2019, associated mortality decreased. This likely reflects advancements in critical care that are improving survival, even as more cases are recognized. AKI, affecting 5% of PSS patients, remained a potent marker of severity, was associated with a sevenfold increased risk of mortality and driven by identifiable risk factors like specific comorbidities and infections. Enhanced early identification of at-risk children is crucial to further improve outcomes.

Indexed as

acute kidney injurychildmortalityrisk factorssevere sepsis

Identifiers

PMID41648052
PMCPMC12868292

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