Limits...
Bacterial sepsis in Brazilian children: a trend analysis from 1992 to 2006.

Mangia CM, Kissoon N, Branchini OA, Andrade MC, Kopelman BI, Carcillo J - PLoS ONE (2011)

Bottom Line: There was a case reduction of 67% over 1992-2006 (p<0.001); however, the mortality rate remained unchanged (from 1992-1996, 20.5%; and from 2002-2006, 19.7%).The human development index (HDI) and mortality rates (MR) by region were: North region 0.76 and 21.7%; Northeast region 0.72 and 27.1%; Central-West 0.81 and 23.5%; South region 0.83 and 12.2% and Southeast region 0.82 and 14.8%, respectively.We concluded that sepsis remains an important health problem in children in Brazil.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Universidade Federal de São Paulo Escola Paulista de Medicina, São Paulo, Brazil.

ABSTRACT

Background: The objective of this study was to determine the epidemiology of hospitalized pediatric sepsis in Brazil (1992-2006) and to compare mortality caused by sepsis to that caused by other major childhood diseases.

Methods and findings: We performed a retrospective descriptive study of hospital admissions using a government database of all hospital affiliated with the Brazilian health system. We studied all hospitalizations in children from 28 days through 19 years with diagnosis of bacterial sepsis defined by the criteria of the International Classification of Diseases (ICD), (Appendix S1). Based on the data studied from 1992 through 2006, the pediatric hospital mortality rate was 1.23% and there were 556,073 pediatric admissions with bacterial sepsis with a mean mortality rate of 19.9%. There was a case reduction of 67% over 1992-2006 (p<0.001); however, the mortality rate remained unchanged (from 1992-1996, 20.5%; and from 2002-2006, 19.7%). Sepsis-hospital mortality rate was substantially higher than pneumonia (0.5%), HIV (3.3%), diarrhea (0.3%), undernutrition (2.3%), malaria (0.2%) and measles (0.7%). The human development index (HDI) and mortality rates (MR) by region were: North region 0.76 and 21.7%; Northeast region 0.72 and 27.1%; Central-West 0.81 and 23.5%; South region 0.83 and 12.2% and Southeast region 0.82 and 14.8%, respectively.

Conclusions: We concluded that sepsis remains an important health problem in children in Brazil. The institution of universal primary care programs has been associated with substantially reduced sepsis incidence and therefore deaths; however, hospital mortality rates in children with sepsis remain unchanged. Implementation of additional health initiatives to reduce sepsis mortality in hospitalized patients could have great impact on childhood mortality rates in Brazil.

Show MeSH

Related in: MedlinePlus

Trends in hospital mortality rates.Legend:---◊--- Male ---▪---Female ---▴--- Both.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3108592&req=5

pone-0014817-g003: Trends in hospital mortality rates.Legend:---◊--- Male ---▪---Female ---▴--- Both.

Mentions: By age group, the mortality rate among children under 1 year old declined over the 14-year period (p = 0.023) but increased among children 1 to 4 years (p<.05) and among children above 5 years (p <0.01) for the entire study period (Figure 2, Table 4). The hospital mortality differed significantly between boys and girls, mean difference, 818.20 (95% confidence interval for difference 559.45 to 1076.95; p = .000) among cohorts (Figure 3). In addition, the mortality rate in girls was higher than boys under 5 years in the last cohort (p<.05) (Figure 4).


Bacterial sepsis in Brazilian children: a trend analysis from 1992 to 2006.

Mangia CM, Kissoon N, Branchini OA, Andrade MC, Kopelman BI, Carcillo J - PLoS ONE (2011)

Trends in hospital mortality rates.Legend:---◊--- Male ---▪---Female ---▴--- Both.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108592&req=5

pone-0014817-g003: Trends in hospital mortality rates.Legend:---◊--- Male ---▪---Female ---▴--- Both.
Mentions: By age group, the mortality rate among children under 1 year old declined over the 14-year period (p = 0.023) but increased among children 1 to 4 years (p<.05) and among children above 5 years (p <0.01) for the entire study period (Figure 2, Table 4). The hospital mortality differed significantly between boys and girls, mean difference, 818.20 (95% confidence interval for difference 559.45 to 1076.95; p = .000) among cohorts (Figure 3). In addition, the mortality rate in girls was higher than boys under 5 years in the last cohort (p<.05) (Figure 4).

Bottom Line: There was a case reduction of 67% over 1992-2006 (p<0.001); however, the mortality rate remained unchanged (from 1992-1996, 20.5%; and from 2002-2006, 19.7%).The human development index (HDI) and mortality rates (MR) by region were: North region 0.76 and 21.7%; Northeast region 0.72 and 27.1%; Central-West 0.81 and 23.5%; South region 0.83 and 12.2% and Southeast region 0.82 and 14.8%, respectively.We concluded that sepsis remains an important health problem in children in Brazil.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Universidade Federal de São Paulo Escola Paulista de Medicina, São Paulo, Brazil.

ABSTRACT

Background: The objective of this study was to determine the epidemiology of hospitalized pediatric sepsis in Brazil (1992-2006) and to compare mortality caused by sepsis to that caused by other major childhood diseases.

Methods and findings: We performed a retrospective descriptive study of hospital admissions using a government database of all hospital affiliated with the Brazilian health system. We studied all hospitalizations in children from 28 days through 19 years with diagnosis of bacterial sepsis defined by the criteria of the International Classification of Diseases (ICD), (Appendix S1). Based on the data studied from 1992 through 2006, the pediatric hospital mortality rate was 1.23% and there were 556,073 pediatric admissions with bacterial sepsis with a mean mortality rate of 19.9%. There was a case reduction of 67% over 1992-2006 (p<0.001); however, the mortality rate remained unchanged (from 1992-1996, 20.5%; and from 2002-2006, 19.7%). Sepsis-hospital mortality rate was substantially higher than pneumonia (0.5%), HIV (3.3%), diarrhea (0.3%), undernutrition (2.3%), malaria (0.2%) and measles (0.7%). The human development index (HDI) and mortality rates (MR) by region were: North region 0.76 and 21.7%; Northeast region 0.72 and 27.1%; Central-West 0.81 and 23.5%; South region 0.83 and 12.2% and Southeast region 0.82 and 14.8%, respectively.

Conclusions: We concluded that sepsis remains an important health problem in children in Brazil. The institution of universal primary care programs has been associated with substantially reduced sepsis incidence and therefore deaths; however, hospital mortality rates in children with sepsis remain unchanged. Implementation of additional health initiatives to reduce sepsis mortality in hospitalized patients could have great impact on childhood mortality rates in Brazil.

Show MeSH
Related in: MedlinePlus