Comparison of PICU Cost and Severity-Adjusted Cost Between Patients With SIRS-Defined Sepsis and Those With Age-Adapted SOFA-Defined Sepsis.

The definition is considered to lack specificity and may lead to the admission of low-risk patients to the pediatric intensive care unit (PICU). The aim of this study was to compare the PICU cost and the severity-adjusted cost between patients with sepsis defined by the and those diagnosed using the age-adapted Sepsis-3 criteria. Septic children identified by the were screened for enrollment. The enrolled children were stratified into two subgroups using the age-adapted Sepsis 3.0 definition. A comparison was made between the subgroups of sepsis 3.0-defined children and non-sepsis 3.0-defined septic children. The Severity Adjusted ICU Cost (SAIC) was used to evaluate the case-mixed severity-adjusted costs of the study population. Coefficients in linear regression analyses in subgroups were calculated for presenting variation of PICU costs for every unit change of PRISM score. A total of 397 children were enrolled. The PICU length of stay was longer in the sepsis 3.0 group than in the non-sepsis 3.0 group [median (IQR), 9.0 (5.0, 15.0) vs. 6.0 (3.0, 9.0); < 0.001]. Pediatric risk of mortality (PRISM) scores and mortality were significantly higher in sepsis 3.0-defined septic patients. The total costs and daily costs in the PICU were both significantly lower in the non-sepsis 3.0 group ( < 0.001). The severity-adjusted ICU cost in the non-sepsis 3.0 group was lower than that in the sepsis 3.0 group [median (IQR), 7,125 (3,588, 11,134) vs. 9,364 (5,680, 15,876); = 0.001]. There was no significant difference among the regression coefficients. The definition does not lead to more PICU costs after considering illness severity. www.ClinicalTrials.gov, identifier: NCT03598127.