| アブストラクト | INTRODUCTION: The survival benefits of treatment at high-volume hospitals (HVHs) are well-documented for several critical pediatric conditions. However, their impact on pediatric sepsis, a leading cause of mortality among children, remains understudied. AIM OF THE STUDY: To investigate the association between hospital case volume and mortality rates in pediatric sepsis. MATERIAL AND METHODS: We conducted a retrospective cohort study using data from the Diagnosis Procedure Combination database. The study included patients who met the following criteria: 1) aged 28 days to 17 years; 2) discharged from the hospital between April 2014 and March 2018; 3) had a sepsis diagnosis coded under the International Classification of Diseases, 10th revision; 4) underwent blood cultures on hospital admission day (day 0) or day 1; 5) received antimicrobial agents on day 0 or 1; and 6) required at least one organ support measure (e.g., mechanical ventilation or vasopressors) on day 0 or 1. Hospitals were categorized by case volume during the study period, with HVHs defined as those in the highest quartile and low-volume hospitals (LVHs) as those in the remaining quartiles. In-hospital mortality rates between HVH and LVH groups were compared using mixed-effects logistic regression analysis with propensity score (PS) matching. RESULTS: A total of 934 pediatric patients were included in the study, with an overall in-hospital mortality rate of 16.1%. Of them, 234 were treated at 5 HVHs (>/=26 patients in 4 years), and 700 at 234 LVHs (<26 patients in 4 years). Upon PS matching, patients treated at HVHs demonstrated significantly lower odds of in-hospital mortality compared with those treated at LVHs (odds ratio, 0.42; 95% confidence interval, 0.22-0.80; P = 0.008). CONCLUSIONS: In pediatric patients with sepsis, treatment at HVHs was associated with lower odds of in-hospital mortality. |
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| ジャーナル名 | Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) |
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| Pubmed追加日 | 2025/2/28 |
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| 投稿者 | Ohki, Shingo; Otani, Makoto; Tomioka, Shinichi; Komiya, Kosaku; Kawamura, Hideki; Nakada, Taka-Aki; Nakagawa, Satoshi; Matsuda, Shinya; Shime, Nobuaki |
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| 組織名 | Graduate School of Biomedical and Health Sciences, Hiroshima University,;Hiroshima, Japan.;Shonan Kamakura General Hospital, Kamakura, Japan.;University of Occupational and Environmental Health, Kitakyushu, Japan.;Kotonoha Collaboration Clinic, Kitakyushu, Japan.;Faculty of Medicine, Oita University, Oita, Japan.;Kagoshima University Hospital, Kagoshima, Japan.;Graduate School of Medicine, Chiba University, Chiba, Japan.;National Center for Child Health and Development, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40017481/ |
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