Abstract
Background: Pediatric severe sepsis is a public health problem with significant morbidities in those who survive. In this article, we aim to present an overview of the important studies highlighting the limited data available pertaining to long-term outcomes of survivors of pediatric severe sepsis. Materials and Methods: A review of literature available was conducted using PUBMED/Medline on pediatric severe sepsis outcomes. Long-term outcomes and health-related quality of life (HRQL) following severe sepsis was defined as any outcome occurring after discharge from the hospital following an episode of severe sepsis which affected either the survivor or the survivor’s family members. Results: Many children are discharged with worse clinical and functional outcomes, depending on their diagnosis, treatments received, psychological effects, and the impact of their illness on their parents. Additionally, they utilize healthcare services more than their peers and are often readmitted soon after discharge. However, pediatric HRQL studies with worthwhile outcome measures are limited and the current data on pediatric sepsis is mainly retrospective. Conclusions: There is significant and longstanding morbidity seen in children and their families following a severe sepsis illness. Further prospective data are required to study the long-term outcomes of sepsis in the pediatric population.
Highlights
Pediatric severe sepsis remains a burdensome public health problem
Keywords used for the literature search included: pediatrics, severe sepsis, health-related quality of life (HRQL), pediatric intensive care unit (PICU), morbidity, long-term outcomes, disability, mortality, epidemiology of sepsis, social impact, readmissions, and septic shock
A recent prospective severe sepsis point prevalence study described morbidity outcomes which lend themselves to future outcome research
Summary
Pediatric severe sepsis remains a burdensome public health problem. More than 42,000 children develop severe sepsis each year in the United States alone, and 4400 of these children die [1]. Hartmen et al showed a steady increase by 81% in the prevalence of sepsis from 1995 to 2005 They noted a decline in case fatalities from 10.3 to 8.9% [3]. These studies may have underestimated the true mortality rate in children with severe sepsis, as they were mostly retrospective studies based on diagnosis codes. An international multicentered prospective point prevalence study was conducted which showed a severe sepsis point prevalence of 8.2% and an increased mortality rate of 25% [1]. Results: Many children are discharged with worse clinical and functional outcomes, depending on their diagnosis, treatments received, psychological effects, and the impact of their illness on their parents. Pediatric HRQL studies with worthwhile outcome measures are limited and the current data on pediatric sepsis is mainly retrospective
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