Abstract
Objectives: Epidemiology and care practices for pediatric sepsis in community hospitals were evaluated using a diagnosis procedure combination (DPC) database. Methods: We collected DPC data from 66 community hospitals nationwide in 2007 and identified 388 pediatric (age, 1 month to 19 years) and 5,215 adult patients using the sepsis-related international classification of disease (ICD)-10 coding. Results: Pediatric sepsis comprised 6.9% of the total number of cases and infants accounted for 46.1% of this population. The incidences of sepsis per 1,000 admissions were 8.4 and 14.5 in pediatric and adult patients, respectively. Rates of in-hospital mortality were significantly lower among pediatric than adult patients (0.5% vs. 33.5%, P < 0.01), as were the need for intensive care procedures and length of ICU stay (P < 0.01). The mean cost per day during admission was about 40,000 yen, which was comparable between pediatric and adult patients. Conclusions: The incidence of sepsis is relatively higher, and the severity and mortality outcomes are lower and better, respectively, among pediatric than adult patients in community hospitals registered by the DPC database. Problems with the structure or clinical application of the ICD-10 coding or specific case-mixes in community hospitals might affect these findings.
