Long Elliot, Borland Meredith L, George Shane, Jani Shefali, Tan Eunicia, Phillips Natalie, Kochar Amit, Craig Simon, Lithgow Anna, Rao Arjun, Whyte Emma, Dalziel Stuart, Hearps Stephen, Gelbart Ben, McNab Sarah, Balamuth Fran, Weiss Scott L, Kuppermann Nathan, Williams Amanda, Babl Franz E
Department of Emergency Medicine, The Royal Children's Hospital, Parkville, Victoria, Australia.
Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Lancet Reg Health West Pac. 2025 Jul 21;60:101608. doi: 10.1016/j.lanwpc.2025.101608. eCollection 2025 Jul.
Paediatric sepsis epidemiology is unclear due to variability in case ascertainment. We describe the epidemiology of community acquired sepsis in Australian and New Zealand children using the Phoenix sepsis criteria.
Prospective observational study conducted in 11 hospitals through the Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network from April 2021 to December 2023. Children aged 0-<18 years with suspected sepsis were included. Demographic information, therapies administered, and outcomes were collected, and the Phoenix sepsis criteria were applied.
Of 822,072 children assessed, 6232 (0.8%) children had suspected sepsis and 306 (<0.1%) met the Phoenix sepsis criteria. Children who met the Phoenix sepsis criteria had higher rates of intensive care unit admission (245/306; 80.1% vs 1080/6232; 17.3%), vasoactive infusion (144/306; 47.1% vs 179/6232; 2.9%) mechanical ventilation (146/306; 47.7% vs 251/6232; 4.0%), and extracorporeal life support (12/306; 3.9% vs 13/6232; 0.2%) compared to the overall cohort. Intensive care unit and hospital length of stay were longer for those meeting Phoenix sepsis criteria than for the overall cohort (median 48.4 h vs 79.8 h and 69.7 h vs 189.8 h, respectively). Overall, 87/6232 (1.4%) patients died within 90 days, 42/306 (13.7%) of whom met Phoenix sepsis criteria.
Hospitalisation for suspected sepsis was relatively infrequent. The Phoenix sepsis criteria identified children with more severe illness and worse outcomes, but underestimated the overall burden of sepsis.
The National Health and Medical Research Council, the Medical Research Futures Fund, The Royal Children's Hospital Foundation, and the Victorian Government.
由于病例确诊的差异，儿童脓毒症的流行病学尚不清楚。我们使用凤凰城脓毒症标准描述澳大利亚和新西兰儿童社区获得性脓毒症的流行病学情况。
2021年4月至2023年12月期间，通过国际急诊儿科研究协作组（PREDICT）网络在11家医院开展了一项前瞻性观察性研究。纳入0至<18岁疑似脓毒症的儿童。收集人口统计学信息、所给予的治疗及结局，并应用凤凰城脓毒症标准。
在评估的822,072名儿童中，6232名（0.8%）儿童疑似脓毒症，306名（<0.1%）符合凤凰城脓毒症标准。与整个队列相比，符合凤凰城脓毒症标准的儿童入住重症监护病房的比例更高（245/306；80.1% 对比1080/6232；17.3%）、血管活性药物输注比例更高（144/306；47.1% 对比179/6232；2.9%）、机械通气比例更高（146/306；47.7% 对比251/6232；4.0%）以及体外生命支持比例更高（12/306；3.9% 对比13/6232；0.2%）。符合凤凰城脓毒症标准的儿童在重症监护病房和医院的住院时间比整个队列更长（中位数分别为48.4小时对比79.8小时以及69.7小时对比189.8小时）。总体而言，87/6232（1.4%）的患者在90天内死亡，其中42/306（13.7%）符合凤凰城脓毒症标准。
疑似脓毒症的住院情况相对不常见。凤凰城脓毒症标准识别出病情更严重、结局更差的儿童，但低估了脓毒症的总体负担。
澳大利亚国家卫生与医学研究委员会、医学研究未来基金、皇家儿童医院基金会和维多利亚州政府。
