Yuanyuan Wang1, Bo Sun, Hongni Yue, Xiaofei Lin, Bing Li, Xiaochun Yang, Chunming Shan, Yujin Fan, Maotian Dong, Yixing Zhang, Wenlong Lin, Xiaofeng Zuo, Ping Su, Yongbo Heng, Jinzhong Xu, Niranjan Kissoon. 1. 1Departments of Pediatrics and Pediatric Critical Care, Children's Hospital of Fudan University, Shanghai, China. 2Department of Pediatrics, Huai'an Maternity and Children's Hospital, Jiangsu, China. 3Department of Pediatrics, Huai'an First People's Hospital, Huai'an, Jiangsu, China. 4Department of Pediatrics, Huai'an Second People's Hospital, Huai'an, Jiangsu, China. 5Department of Pediatrics, Huaiyin District Hospital, Huai'an, Jiangsu, China. 6Department of Pediatrics, Chuzhou District Hospital, Huai'an, Jiangsu, China. 7Department of Pediatrics, Xuyi County Hospital, Huai'an, Jiangsu, China. 8Department of Pediatrics, Xuyi County Hospital for Traditional Chinese Medicine, Huai'an, Jiangsu, China. 9Department of Pediatrics, Lianshui County Hospital, Huai'an, Jiangsu, China. 10Department of Pediatrics, Lianshui County Hospital for Traditional Chinese Medicine, Huai'an, Jiangsu, China. 11Department of Pediatrics, Jinhu County Hospital, Huai'an, Jiangsu, China. 12Department of Pediatrics, Hongze County Hospital, Huai'an, Jiangsu, China. 13Department of Pediatrics, University of British-Columbia and BC Children's Hospital, Vancouver, Canada.
Abstract
OBJECTIVE: To determine the prevalence, treatment, and outcomes of sepsis at regional hospitals in Huai'an, Jiangsu, China. DESIGN: Prospective data registry using a descriptive clinical epidemiologic approach through a collaborative network. SETTING: Pediatric departments in 11 regional city and county referral hospitals serving 843,000 children (exclusive of neonates). SUBJECTS: All admissions (n = 27,836) of patients from 28 days to 15 years old from September 1, 2010, to August 31, 2011. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 1,530 patients met the 2005 international consensus definition of sepsis, corresponding to an estimated incidence of 181/100,000 children, with 80% under 5 years old, and in 10% (153), severe sepsis or septic shock developed. The overall case fatality rate for sepsis was 3.5% (53/1,530) or 34.6% (53/153) in those in whom severe sepsis or septic shock developed. Treatment varied widely and in many instances did not conform to international guidelines as reflected by inadequate use of antibiotics, corticosteroids, vasoactive agents, and inotropes. CONCLUSIONS: We first report the prevalence and outcome of pediatric sepsis based on a regional hospital network in China. The diverse treatment approaches and practice at low-level clinics suggest the need for clinical implementation of internationally recognized strategy to improve the care standard in resource-limited regional hospitals.
OBJECTIVE: To determine the prevalence, treatment, and outcomes of sepsis at regional hospitals in Huai'an, Jiangsu, China. DESIGN: Prospective data registry using a descriptive clinical epidemiologic approach through a collaborative network. SETTING: Pediatric departments in 11 regional city and county referral hospitals serving 843,000 children (exclusive of neonates). SUBJECTS: All admissions (n = 27,836) of patients from 28 days to 15 years old from September 1, 2010, to August 31, 2011. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 1,530 patients met the 2005 international consensus definition of sepsis, corresponding to an estimated incidence of 181/100,000 children, with 80% under 5 years old, and in 10% (153), severe sepsis or septic shock developed. The overall case fatality rate for sepsis was 3.5% (53/1,530) or 34.6% (53/153) in those in whom severe sepsis or septic shock developed. Treatment varied widely and in many instances did not conform to international guidelines as reflected by inadequate use of antibiotics, corticosteroids, vasoactive agents, and inotropes. CONCLUSIONS: We first report the prevalence and outcome of pediatric sepsis based on a regional hospital network in China. The diverse treatment approaches and practice at low-level clinics suggest the need for clinical implementation of internationally recognized strategy to improve the care standard in resource-limited regional hospitals.
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