{"id":30521,"date":"2026-06-10T04:18:00","date_gmt":"2026-06-09T20:18:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30521"},"modified":"2026-06-10T05:42:44","modified_gmt":"2026-06-09T21:42:44","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%bd%bf%e7%94%a8%e4%b8%b4%e5%ba%8a%e6%95%b0%e6%8d%ae%e4%bc%b0%e8%ae%a1%e7%be%8e%e5%9b%bd%e5%8c%bb%e9%99%a2%e5%86%85%e5%84%bf%e7%ab%a5%e8%84%93","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30521","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u4f7f\u7528\u4e34\u5e8a\u6570\u636e\u4f30\u8ba1\u7f8e\u56fd\u533b\u9662\u5185\u513f\u7ae5\u8113\u6bd2\u75c7"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Caring for the Critically Ill Patient<\/p>\n\n\n\n

National Estimates of Pediatric Sepsis in US Hospitals Using Clinical Data<\/h1>\n\n\n\n

Chanu Rhee, Fran Balamuth, Kevin Dysart, et al<\/h3>\n\n\n\n

JAMA Published Online: March 22, 2026<\/h3>\n\n\n\n

doi: 10.1001\/jama.2026.3100<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  What is the burden of nonneonatal pediatric sepsis in US hospitals using an electronic health record\u2013based surveillance definition aligned with the 2024 Phoenix criteria?<\/p>\n\n\n\n

Findings<\/strong>  In this retrospective cohort study of more than 3.9 million pediatric hospitalizations, a Pediatric Sepsis Event (PSE) definition identified sepsis in 1.3% of encounters with 10.1% in-hospital mortality and in 17.8% of hospitalizations that culminated in death, corresponding to more than 18\u202f000 US cases and more than 1800 deaths annually. Neither sepsis cases nor deaths changed significantly from 2016 to 2022.<\/p>\n\n\n\n

Meaning<\/strong>  The PSE criteria provide a standardized, scalable framework for pediatric sepsis surveillance and underscore its substantial burden among hospitalized US children.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Pediatric sepsis causes substantial morbidity and mortality, but population surveillance relies on administrative codes with limited and variable accuracy.<\/p>\n\n\n\n

Objective<\/strong>  To estimate US national incidence, mortality, and trends of sepsis in nonneonatal children using a Pediatric Sepsis Event (PSE) definition adapted from the 2024 Phoenix criteria for scalable electronic health record (EHR)\u2013based surveillance using routinely captured clinical data.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  Retrospective cohort study of 3.9 million hospitalizations (age, >30 days to 17 years) in 2 EHR datasets: Epic Cosmos (245 health care systems, 2016-2023) and HCA Healthcare (146 hospitals, 2018-2023). Secondary datasets were analyzed to assess feasibility of implementation and face validity across heterogeneous settings. The PSE was validated through medical record reviews of 581 high-risk encounters at 3 geographically diverse hospitals.<\/p>\n\n\n\n

Exposures<\/strong>  A PSE required presumed infection with concurrent organ dysfunction using Phoenix-derived thresholds adapted for routine EHR data. Septic shock was defined as a PSE with cardiovascular dysfunction.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Sepsis incidence, characteristics, and in-hospital mortality were calculated. Sensitivity and specificity of PSE for physician-adjudicated Phoenix sepsis were compared with administrative codes for severe sepsis\/septic shock. National sepsis case counts and deaths in 2022 and temporal trends from 2016 to 2022 were estimated using regression models.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Among 3\u202f925\u202f809 pediatric hospitalizations from 2016 to 2023, 51\u202f542 sepsis cases (mean age, 6.6 [SD, 6.0] years; 22\u202f840 [44.3%] female) were identified (1.3% incidence); 37\u202f405 (72.6%) were community onset and 31\u202f744 (61.6%) had septic shock. In-hospital mortality was 10.1% and sepsis was present in 17.8% of hospitalizations that culminated in death. Incidence, characteristics, and mortality were broadly consistent across secondary datasets. On medical record review, the PSE definition had 69.9% sensitivity (95% CI, 58.1%-79.8%) and 93.1% specificity (95% CI, 89.6%-95.7%), with higher sensitivity than and comparable specificity with administrative codes. National estimates for 2022 were 18\u202f231 sepsis cases (95% CI, 16\u202f129-20\u202f334) and 1877 deaths(95% CI, 1629-2126). Neither sepsis cases nor deaths changed significantly from 2016 to 2022 (annual change, 0.2% [95% CI, \u22122.2% to 2.7%] and 0.3% [95% CI, \u22123.1% to 3.8%], respectively).<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  An EHR-based definition for pediatric sepsis demonstrated strong validity compared with physician-adjudicated Phoenix sepsis and identified sepsis in 1.3% of pediatric hospitalizations with 10% mortality, corresponding to more than 18\u202f000 cases and more than 1800 deaths annually in the US.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Caring for the Critically […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30521"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30521"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30521\/revisions"}],"predecessor-version":[{"id":31047,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30521\/revisions\/31047"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30521"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30521"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30521"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}