A National Approach to Pediatric Sepsis Surveillance
| Autor: | Anthony E. Fiore, Charles G. Macias, Scott L. Weiss, Patrick W. Brady, Michael S. D. Agus, Carmen Sulton, Karen M. Puopolo, Heather E Hsu, Chanu Rhee, Jeffrey S. Gerber, Michael Klompas, Runa H Gokhale, Raymund Dantes, Grace M. Lee, Lauren Epstein, Niranjan Kissoon, Fran Balamuth, Richard J. Brilli, Benny L. Joyner, Joseph A. Carcillo, Francisca Abanyie |
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| Rok vydání: | 2019 |
| Předmět: |
Pediatric Research Initiative
medicine.medical_specialty MEDLINE Medical and Health Sciences Pediatrics Sepsis 03 medical and health sciences Age Distribution 0302 clinical medicine Cost of Illness Pediatric sepsis Clinical Research Multidisciplinary approach 030225 pediatrics Chart review medicine Electronic Health Records Humans Child Intensive care medicine Pediatric business.industry Prevention Inflammatory and immune system Incidence Public health Psychology and Cognitive Sciences Organ dysfunction Infant Hematology medicine.disease United States Infectious Diseases Good Health and Well Being Population Surveillance Pediatrics Perinatology and Child Health Special Articles Professional association Patient Safety medicine.symptom Infection business |
| Zdroj: | Pediatrics Pediatrics, vol 144, iss 6 |
| ISSN: | 1098-4275 0031-4005 |
| Popis: | Pediatric sepsis is a major public health concern, and robust surveillance tools are needed to characterize its incidence, outcomes, and trends. The increasing use of electronic health records (EHRs) in the United States creates an opportunity to conduct reliable, pragmatic, and generalizable population-level surveillance using routinely collected clinical data rather than administrative claims or resource-intensive chart review. In 2015, the US Centers for Disease Control and Prevention recruited sepsis investigators and representatives of key professional societies to develop an approach to adult sepsis surveillance using clinical data recorded in EHRs. This led to the creation of the adult sepsis event definition, which was used to estimate the national burden of sepsis in adults and has been adapted into a tool kit to facilitate widespread implementation by hospitals. In July 2018, the Centers for Disease Control and Prevention convened a new multidisciplinary pediatric working group to tailor an EHR-based national sepsis surveillance approach to infants and children. Here, we describe the challenges specific to pediatric sepsis surveillance, including evolving clinical definitions of sepsis, accommodation of age-dependent physiologic differences, identifying appropriate EHR markers of infection and organ dysfunction among infants and children, and the need to account for children with medical complexity and the growing regionalization of pediatric care. We propose a preliminary pediatric sepsis event surveillance definition and outline next steps for refining and validating these criteria so that they may be used to estimate the national burden of pediatric sepsis and support site-specific surveillance to complement ongoing initiatives to improve sepsis prevention, recognition, and treatment. |
| Databáze: | OpenAIRE |
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