Sepsis estimated to occur in more than 18,000 pediatric hospitalizations annually, leading to more than 1,800 deaths each year in the U.S.
Investigators from Ann & Robert H. Lurie Children’s Hospital of Chicago were among the multicenter team of experts who determined more accurate national estimates of non-neonatal pediatric sepsis using readily available clinical data from electronic health records. As they recently reported in JAMA, sepsis occurred in 1.3 percent of pediatric hospitalizations, with 10 percent mortality rate, corresponding to more than 18,000 U.S. cases and more than 1,800 deaths annually. Neither pediatric sepsis incidence nor mortality changed significantly from 2016 to 2022.
“The process and definition of pediatric sepsis we developed and applied allows for accurate and uniform epidemiological surveillance that is essential for improving future care,” said co-author Elizabeth Alpern, MD, MSCE, vice chair and professor of Pediatrics, as well as Division Head of Emergency Medicine at Lurie Children’s. “We especially need to move the needle on mortality from pediatric sepsis in the U.S., since we found that hasn’t changed over the six-year period we studied. We need to learn from the centers that achieve better outcomes and implement those practices nationally.”
Her co-author L. Nelson Sanchez-Pinto, MD, MBI, agrees. “We can’t improve what we can’t measure,” he said. “The huge national burden of pediatric sepsis mortality we found is a call to arms. Now that we can compare outcomes from institutions across the country, we can expand what works to create tangible impact.”
Sanchez-Pinto is an associate professor of Pediatrics and of Preventive Medicine, and a Critical Care physician at Lurie Children’s.
To reach the current estimates of pediatric sepsis incidence and mortality, scientists analyzed over 3.9 million hospitalizations. They also found that 72 percent of sepsis cases began before the child was hospitalized, which underscores that sepsis can happen in an otherwise healthy child.
“The bulk of the problem is recognition of sepsis,” Sanchez-Pinto said. “We encourage parents to learn the signs and symptoms of pediatric sepsis, and if it is suspected to bring their child to the hospital immediately so treatment can begin as soon as possible.”
In order to help parents detect sepsis and seek treatment right away, the Sepsis Alliance provides a simple mnemonic guideline, called It’s About TIME, which describes a combination of symptoms that call for immediate medical attention:
T: Temperature, higher or lower than normal
I: Infection signs or symptoms
M: Mental decline, confused, sleepy, difficult to rouse
E: Extremely ill, severe pain, discomfort, shortness of breath
“Early recognition and treatment of sepsis can save lives,” Alpern emphasized. “Raising awareness among families hopefully will help more children survive sepsis.”
The study was funded in part by the Centers for Disease Control and Prevention (CDC).
Alpern holds the George M. Eisenberg Professorship in Pediatrics. Sanchez-Pinto is a Warren and Eloise Batts Research Scholar.
Ann & Robert H. Lurie Children’s Hospital of Chicago is a nonprofit organization committed to providing access to exceptional care for every child. It is the only independent, research-driven children’s hospital in Illinois and one of less than 35 nationally.
Research at Lurie Children’s is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report.Emergency medicine-focused research at Lurie Children’s is conducted through the Grainger Research Program in Pediatric Emergency Medicine.
