Association between hospital case volume and mortality in pediatric sepsis: A retrospective observational study using a Japanese nationwide inpatient database
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31 gen 2025
INFORMAZIONI SU QUESTO ARTICOLO
Categoria dell'articolo: Research Article
Pubblicato online: 31 gen 2025
Pagine: 87 - 94
Ricevuto: 05 set 2024
Accettato: 15 gen 2025
DOI: https://doi.org/10.2478/jccm-2025-0006
Parole chiave
© 2025 Shingo Ohki et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Fig. 1.
Fig. 2.
Fig. 3.
Odds ratio of in-hospital mortality for the high-volume hospital group (vs_ low-volume hospital group)
| Main analysis | ||
| PS matching (n=468) | 0.42 (0.22–0.80) | 0.008 |
| Sensitivity analysis | ||
| IPTW (n=934) | 0.49 (0.29–0.83) | 0.009 |
| PS matching excluding patients referred from another hospital (n=232) | 0.36 (0.14–0.90) | 0.030 |
| PS matching excluding patients who received CPR on day 0 |
0.32 (0.13–0.78) | 0.012 |
Patient characteristics and treatment before and after PS matching
| Age (years) | 3.1 (4.3) | 5.2 (5.6) | 0.438 | 3.1 (4.3) | 3.1 (4.5) | 0.011 |
| Male | 118 (50.4) | 402 (57.4) | 0.141 | 118 (50.4) | 112 (47.9) | 0.051 |
| Referral from another hospital | 118 (50.4) | 403 (57.6) | 0.144 | 118 (50.4) | 100 (42.7) | 0.154 |
| Transport by ambulance | 144 (61.5) | 355 (50.7) | 0.219 | 144 (61.5) | 141 (60.3) | 0.026 |
| Treatment on day 0 |
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| Mechanical ventilation | 218 (93.2) | 612 (87.4) | 0.194 | 218 (93.2) | 214 (91.5) | 0.064 |
| Cardiopulmonary resuscitation | 12 (5.1) | 61 (8.7) | 0.141 | 12 (5.1) | 13 (5.6) | 0.019 |
| Mechanical circulatory support | 6 (2.6) | 12 (1.7) | 0.059 | 6 (2.6) | 5 (2.1) | 0.028 |
| Inotropes/vasopressors | 122 (52.1) | 373 (53.3) | 0.023 | 122 (52.1) | 125 (53.4) | 0.026 |
| Blood purification | 14 (6.0) | 62 (8.9) | 0.110 | 14 (6.0) | 12 (5.1) | 0.037 |
| Blood transfusion | 87 (37.2) | 233 (33.3) | 0.081 | 87 (37.2) | 85 (36.3) | 0.018 |
| Intravenous immunoglobulin | 42 (18.0) | 204 (29.1) | 0.266 | 42 (18.0) | 40 (17.1) | 0.022 |
| Albumin | 69 (29.5) | 170 (24.3) | 0.117 | 69 (29.5) | 66 (28.2) | 0.028 |
| Recombinant thrombomodulin | 13 (5.6) | 127 (18.1) | 0.397 | 13 (5.6) | 15 (6.4) | 0.036 |
| Antithrombin | 24 (10.3) | 122 (17.4) | 0.209 | 24 (10.3) | 27 (11.5) | 0.041 |
| Corticosteroids | 86 (36.8) | 284 (40.6) | 0.078 | 86 (36.8) | 88 (37.6) | 0.018 |
| Enteral nutrition | 103 (44.0) | 154 (22.0) | 0.481 | 103 (44.0) | 92 (39.3) | 0.095 |
List of International Classification of Diseases, 10th Revision codes for sepsis
| A02.1 | Salmonella sepsis |
| A20.7 | Septicaemic plague |
| A22.7 | Anthrax sepsis |
| A26.7 | Erysipelothrix sepsis |
| A32.7 | Listerial sepsis |
| A39.2 | Acute meningococcaemia |
| A39.3 | Chronic meningococcaemia |
| A39.4 | Meningococcaemia, unspecified |
| A40.0 | Sepsis due to streptococcus, group A |
| A40.1 | Sepsis due to streptococcus, group B |
| A40.2 | Sepsis due to streptococcus, group D |
| A40.3 | Sepsis due to Streptococcus pneumoniae |
| A40.8 | Other streptococcal sepsis |
| A40.9 | Streptococcal sepsis, unspecified |
| A41.0 | Sepsis due to Staphylococcus aureus |
| A41.1 | Sepsis due to other specified staphylococcus |
| A41.2 | Sepsis due to unspecified staphylococcus |
| A41.3 | Sepsis due to Haemophilus influenzae |
| A41.4 | Sepsis due to anaerobes |
| A41.5 | Sepsis due to other gram-negative organisms |
| A41.8 | Other specified sepsis |
| A41.9 | Sepsis, unspecified |
| A42.7 | Actinomycotic sepsis |
| B37.7 | Candidal sepsis |
| O85 | Puerperal sepsis |
| P36.0 | Sepsis of newborn due to streptococcus, group B |
| P36.1 | Sepsis of newborn due to other and unspecified streptococci |
| P36.2 | Sepsis of newborn due to Staphylococcus aureus |
| P36.3 | Sepsis of newborn due to other and unspecified staphylococci |
| P36.4 | Sepsis of newborn due to Escherichia coli |
| P36.5 | Sepsis of newborn due to anaerobes |
| P36.8 | Other bacterial sepsis of newborn |
| P36.9 | Bacterial sepsis of newborn, unspecified |