Epidemiology of community acquired sepsis in children in Australia and New Zealand: a multicentre prospective cohort study

IF 8.1 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet Regional Health: Western Pacific Pub Date : 2025-07-01 DOI:10.1016/j.lanwpc.2025.101608

Elliot Long , Meredith L. Borland , Shane George , Shefali Jani , Eunicia Tan , Natalie Phillips , Amit Kochar , Simon Craig , Anna Lithgow , Arjun Rao , Emma Whyte , Stuart Dalziel , Stephen Hearps , Ben Gelbart , Sarah McNab , Fran Balamuth , Scott L. Weiss , Nathan Kuppermann , Amanda Williams , Franz E. Babl , Celine Lee

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引用次数: 0

Abstract

Background

Paediatric sepsis epidemiology is unclear due to variability in case ascertainment. We describe the epidemiology of community acquired sepsis in Australian and New Zealand children using the Phoenix sepsis criteria.

Methods

Prospective observational study conducted in 11 hospitals through the Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network from April 2021 to December 2023. Children aged 0–<18 years with suspected sepsis were included. Demographic information, therapies administered, and outcomes were collected, and the Phoenix sepsis criteria were applied.

Findings

Of 822,072 children assessed, 6232 (0.8%) children had suspected sepsis and 306 (<0.1%) met the Phoenix sepsis criteria. Children who met the Phoenix sepsis criteria had higher rates of intensive care unit admission (245/306; 80.1% vs 1080/6232; 17.3%), vasoactive infusion (144/306; 47.1% vs 179/6232; 2.9%) mechanical ventilation (146/306; 47.7% vs 251/6232; 4.0%), and extracorporeal life support (12/306; 3.9% vs 13/6232; 0.2%) compared to the overall cohort. Intensive care unit and hospital length of stay were longer for those meeting Phoenix sepsis criteria than for the overall cohort (median 48.4 h vs 79.8 h and 69.7 h vs 189.8 h, respectively). Overall, 87/6232 (1.4%) patients died within 90 days, 42/306 (13.7%) of whom met Phoenix sepsis criteria.

Interpretation

Hospitalisation for suspected sepsis was relatively infrequent. The Phoenix sepsis criteria identified children with more severe illness and worse outcomes, but underestimated the overall burden of sepsis.

Funding

The National Health and Medical Research Council, the Medical Research Futures Fund, The Royal Children's Hospital Foundation, and the Victorian Government.

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.