Authors: Silent Threats: Pediatric Sepsis Sana Ur Rahman

Abstract

In 2017, over 80% of the 6.64 million annual deaths in children and adolescents worldwide occurred in low- and middle-income countries (LMICs) (1). Acute pediatric illnesses such as sepsis, pneumonia, diarrheal disease, and trauma are the leading causes of death and disability beyond the neonatal period in these regions, where critical care resources are often limited.

Objective The primary objective of this study is to determine the incidence of sepsis in pediatric patients. The secondary objective is to assess the outcomes of sepsis patients in the emergency department (ED), including mortality rates and length of stay, to identify the need for critical care or high dependency units

Method This retrospective study analyzed data from the pediatric emergency room at a tertiary care hospital PIMS Hospital Children ER and Ghulam Muhammad Mahar hospital Sukkar Children ER supported by the Child Life Foundation throughout the year 2024. The facility, which does not have a pediatric intensive care unit or a high dependency unit, consists of around 50 beds, a resuscitation room, cardiac monitors, infusion pump, oxygen and medications, a step-down area, and an observation area. The study included all patients from the first day of life to 9-year-old who were diagnosed with sepsis based on clinical and laboratory findings. The data examined presenting complaints, age, triage category, length of stay, and disposition outcomes. Data was collected from electronic medical records and kept confidential.

Results A total of 180725 patients visited the pediatric emergency room in 2024, with 8.25 % (n=14909) diagnosed with sepsis. Of these Sepsis cases, 42% (n=6338) were classified as critical (P1), 4% (n=565) as mild (P3), and 52% (n=6338) as needing observation and treatment at the bedside (P2). The average length of stay is 1.09 days. 44 % (n=6530) of the children were discharged from the ED, 15% (n=2302) were admitted to the hospital, and 8% (n=1234) succumbed to the illness. Additionally, 17% (n=2532) of patients were either referred, due to overcrowding and space constraints in the ED. The maximum length of stay in the ED was 480 hours (about 3weeks), with an average length of stay for P1 and P2 patients being 48 hours (about 2 days). Among patients who died in the ED, the average length of stay was 83 hours (about 3.49 days), while for those referred or admitted to the main hospital, the average length of stay was 43 and 36 hours (about 2 days), respectively.

Keywords: Sepsis, mortality, children, length of stay, emergency department

References:

Arias E, MacDorman MF, Strobino DM, Guyer B. Annual summary of vital statistics. Pediatrics. 2003;112:1215–30. [PubMed] [Google Scholar

Keywords: Sepsis, mortality, children, length of stay, emergency department, Pediatircs