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Patient and hospital correlates of clinical outcomes and resource utilization in severe pediatric sepsis.
Pediatrics. 2007 Mar; 119(3):487-94.Ped

Abstract

OBJECTIVE

Our goal was to describe patient and hospital characteristics associated with in-hospital mortality, length of stay, and charges for critically ill children with severe sepsis.

METHODS

Our study consisted of a retrospective study of children 0 to 19 years of age hospitalized with severe sepsis using the 2003 Kids' Inpatient Database. We generated national estimates of rates of hospitalization and then compared in-hospital mortality, length of stay, and total charges according to patient and hospital characteristics using multivariable regression methods. Severity of illness was measured by using all-patient refined diagnosis-related group severity of illness classification into minor, moderate, major, and extreme severity.

RESULTS

There were an estimated 21,448 hospitalizations for severe pediatric sepsis nationally in 2003. The in-hospital mortality rate was 4.2%. Comorbid illness was present in 34% of hospitalized children. Most (70%) of the extremely ill children were admitted to children's hospitals. Length of stay was longer among patients with higher illness severity and nonsurvivors compared with survivors (13.5 vs 8.5 days). Hospitalizations at urban or children's hospitals were also associated with longer length of stay than nonchildren's or rural hospitals, respectively. Higher charges were associated with higher illness severity, and nonsurvivors had 2.5-fold higher total charges than survivors. Also, higher charges were observed among hospitalizations in urban or children's hospitals. In multivariable regression analysis, multiple comorbid illnesses, multiple organ dysfunction, and greater severity of illness were associated with higher odds of mortality and longer length of stay. Higher hospital charges and longer length of stay were observed among transfer hospitalizations and among hospitalizations to children's hospitals and nonchildren's teaching hospitals compared with hospitals, which had neither children's nor teaching status.

CONCLUSIONS

Mortality from severe pediatric sepsis is associated with patient illness severity, comorbid illness, and multiple organ dysfunction. Many characteristics are associated with resource consumption, including type of hospital, source of admission, and illness severity.

Authors+Show Affiliations

Division of Pediatric Critical Care Medicine, University of Michigan, Ann Arbor, Michigan, USA. fodetola@med.umich.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17332201

Citation

Odetola, Folafoluwa O., et al. "Patient and Hospital Correlates of Clinical Outcomes and Resource Utilization in Severe Pediatric Sepsis." Pediatrics, vol. 119, no. 3, 2007, pp. 487-94.
Odetola FO, Gebremariam A, Freed GL. Patient and hospital correlates of clinical outcomes and resource utilization in severe pediatric sepsis. Pediatrics. 2007;119(3):487-94.
Odetola, F. O., Gebremariam, A., & Freed, G. L. (2007). Patient and hospital correlates of clinical outcomes and resource utilization in severe pediatric sepsis. Pediatrics, 119(3), 487-94.
Odetola FO, Gebremariam A, Freed GL. Patient and Hospital Correlates of Clinical Outcomes and Resource Utilization in Severe Pediatric Sepsis. Pediatrics. 2007;119(3):487-94. PubMed PMID: 17332201.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patient and hospital correlates of clinical outcomes and resource utilization in severe pediatric sepsis. AU - Odetola,Folafoluwa O, AU - Gebremariam,Achamyeleh, AU - Freed,Gary L, PY - 2007/3/3/pubmed PY - 2007/3/28/medline PY - 2007/3/3/entrez SP - 487 EP - 94 JF - Pediatrics JO - Pediatrics VL - 119 IS - 3 N2 - OBJECTIVE: Our goal was to describe patient and hospital characteristics associated with in-hospital mortality, length of stay, and charges for critically ill children with severe sepsis. METHODS: Our study consisted of a retrospective study of children 0 to 19 years of age hospitalized with severe sepsis using the 2003 Kids' Inpatient Database. We generated national estimates of rates of hospitalization and then compared in-hospital mortality, length of stay, and total charges according to patient and hospital characteristics using multivariable regression methods. Severity of illness was measured by using all-patient refined diagnosis-related group severity of illness classification into minor, moderate, major, and extreme severity. RESULTS: There were an estimated 21,448 hospitalizations for severe pediatric sepsis nationally in 2003. The in-hospital mortality rate was 4.2%. Comorbid illness was present in 34% of hospitalized children. Most (70%) of the extremely ill children were admitted to children's hospitals. Length of stay was longer among patients with higher illness severity and nonsurvivors compared with survivors (13.5 vs 8.5 days). Hospitalizations at urban or children's hospitals were also associated with longer length of stay than nonchildren's or rural hospitals, respectively. Higher charges were associated with higher illness severity, and nonsurvivors had 2.5-fold higher total charges than survivors. Also, higher charges were observed among hospitalizations in urban or children's hospitals. In multivariable regression analysis, multiple comorbid illnesses, multiple organ dysfunction, and greater severity of illness were associated with higher odds of mortality and longer length of stay. Higher hospital charges and longer length of stay were observed among transfer hospitalizations and among hospitalizations to children's hospitals and nonchildren's teaching hospitals compared with hospitals, which had neither children's nor teaching status. CONCLUSIONS: Mortality from severe pediatric sepsis is associated with patient illness severity, comorbid illness, and multiple organ dysfunction. Many characteristics are associated with resource consumption, including type of hospital, source of admission, and illness severity. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/17332201/Patient_and_hospital_correlates_of_clinical_outcomes_and_resource_utilization_in_severe_pediatric_sepsis_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=17332201 DB - PRIME DP - Unbound Medicine ER -