Association between hospital case volume and mortality in pediatric sepsis: A retrospective observational study using a Japanese nationwide inpatient database
Rattachement africain : jp. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Introduction: The survival benefits of treatment at high-volume hospitals (HVHs) are well-documented for several critical pediatric conditions. However, their impact on pediatric sepsis, a leading cause of mortality among children, remains understudied. Aim of the study: To investigate the association between hospital case volume and mortality rates in pediatric sepsis. Material and Methods: We conducted a retrospective cohort study using data from the Diagnosis Procedure Combination database. The study included patients who met the following criteria: 1) aged 28 days to 17 years; 2) discharged from the hospital between April 2014 and March 2018; 3) had a sepsis diagnosis coded under the International Classification of Diseases, 10th revision; 4) underwent blood cultures on hospital admission day (day 0) or day 1; 5) received antimicrobial agents on day 0 or 1; and 6) required at least one organ support measure (e.g., mechanical ventilation or vasopressors) on day 0 or 1. Hospitals were categorized by case volume during the study period, with HVHs defined as those in the highest quartile and low-volume hospitals (LVHs) as those in the remaining quartiles. In-hospital mortality rates between HVH and LVH groups were compared using mixed-effects logistic regression analysis with propensity score (PS) matching. Results: A total of 934 pediatric patients were included in the study, with an overall in-hospital mortality rate of 16.1%. Of them, 234 were treated at 5 HVHs (≥26 patients in 4 years), and 700 at 234 LVHs (<26 patients in 4 years). Upon PS matching, patients treated at HVHs demonstrated significantly lower odds of in-hospital mortality compared with those treated at LVHs (odds ratio, 0.42; 95% confidence interval, 0.22-0.80; P = 0.008). Conclusions: In pediatric patients with sepsis, treatment at HVHs was associated with lower odds of in-hospital mortality.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Association between hospital case volume and mortality in pediatric sepsis: A retrospective observational study using a Japanese nationwide inpatient database
- Date Crossref
- 01/01/2025
- Éditeur
- Walter de Gruyter GmbH
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Hiroshima University pays non établi dans la noticeUniversité ou école supérieure
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Shonan Kamakura General Hospital pays non établi dans la noticeÉtablissement de santé
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University of Occupational and Environmental Health Japan pays non établi dans la noticeUniversité ou école supérieure
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Oita University pays non établi dans la noticeUniversité ou école supérieure
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Kagoshima University Hospital pays non établi dans la noticeÉtablissement de santé
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Chiba University pays non établi dans la noticeUniversité ou école supérieure
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National Center For Child Health and Development pays non établi dans la noticeOrganisme public
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Graduate School of Biomedical and Health Sciences pays non établi dans la noticeUniversité ou école supérieure
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Kotonoha Collaboration Clinic pays non établi dans la noticeÉtablissement de santé
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Faculty of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Graduate School of Medicine pays non établi dans la noticeUniversité ou école supérieure
Hiroshima University, Shonan Kamakura General Hospital et University of Occupational and Environmental Health Japan, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.