ABSTRACT

Background: Sepsis causes significant pediatric morbidity and mortality in developing countries. This audit describes the outcome of pediatric sepsis in the University Hospital of the West Indies (UHWI), Jamaica using administrative data from hospital records during 2010 to 2014.

Methods: Data were abstracted from electronic discharge summaries of children hospitalized at the UHWI, a tertiary centre that accepts referral for newborns and children with complex disorders. Medical records review of children aged 0-16 years, hospitalized with a diagnosis of sepsis, septicemia and neonatal sepsis using the international classification of diseases 10th Revision (ICD code 10) was undertaken. Demographic and outcomes data were extracted.

Results: Among 7,211 children aged 0 to 16 years who were admitted, sepsis accounted for 801 hospitalizations in 782 children with a male:female ratio of 1.27 to 1. Neonates comprised 79% (n=691) and 37% (n=250) were preterm. Median duration of hospitalization was 10 days (range 0 to 366 days, IQR was 7 to 19 days). The sepsis-attributable mortality rate was 10.1 % (n=70) in neonates and was higher in preterm vs. term neonates (18.4 % (n=46/250) versus 6.0% (26/434), respectively.  The annual crude mortality rate for pediatric sepsis was 9% to 11% (12 per 1000 pediatric hospitalizations).

Conclusions: Sepsis accounts for a high number of admissions and consumes significant resources as evidenced by long duration of hospitalization. The mortality rate for pediatric sepsis is high especially in newborns. Targeted Interventions are needed to reduce sepsis-attributable burden and improve outcomes established by the Global Sepsis Alliance and United Nations’ Sustainable Development Goals.