More than half of children admitted with sepsis had been seen in the previous week

Design

Retrospective cohort using an administrative claims database

Population

6,928 paediatric sepsis hospitalisations, US, 2016-2022

Primary outcome

Any healthcare encounter in the 7 days before admission

Effect

53.5% had an encounter; 28.2% an ED visit; 38.9% of encounters infection-related

This retrospective study used a US insurance claims database to examine 6,928 sepsis admissions in children aged 0 to 18 between 2016 and 2022. Nearly two-thirds had a complex chronic condition, and the median age was 10.

In the seven days before admission, 53.5% had a healthcare encounter: 33.7% an outpatient visit, 28.2% an emergency department visit and 6.2% an inpatient stay. Among those with an encounter, 38.9% had an infection-related diagnosis recorded. Ventilation, intensive care use and length of stay did not differ between children with and without a previous encounter.

Claims data cannot show whether sepsis was present and missed at those visits. But they show that the week before admission is often a chance to catch it, and that re-presentation should raise concern rather than reassure.

• Treat a child returning within a week with an infective illness as higher risk, and reassess fully.
• Measure heart rate, respiratory rate, capillary refill and mental state at every febrile visit, not just temperature.
• Take particular care with children with complex chronic conditions, who made up most admissions.
• Give explicit, written safety-netting advice at every febrile discharge.

Why it matters

Most children admitted with sepsis had already been seen, so the earlier visit is where it is most likely to be caught.

Don't overread it

Claims data cannot show that sepsis was present, or missed, at the earlier visits.

The statistics, in plain English

These are proportions from claims data, so they show how often contact happened, not how often sepsis was missed. The population was insured US children, most with chronic conditions, so the numbers may differ elsewhere.

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