New Algorithm Tracks Sepsis Incidence Among Pediatric Patients

Researchers at Children’s Hospital of Philadelphia (CHOP) have developed a new algorithm that can track the epidemiology of sepsis among pediatric patients, allowing for more accurate data collection and improved treatment of the condition.

In a study published in Pediatric Critical Care Medicine, the researchers noted that tracking the incidence of sepsis is crucial for understanding the disease. Sepsis, a deadly complication to infection that occurs when the immune system turns on itself, is the leading cause of death in hospitals and contributes to high healthcare costs.

To date, there hasn’t been an effective tool for monitoring sepsis in the pediatric population, the team said. Current methods involve collecting insurance claims data or manual chart review, but these approaches are often inconsistent and leave out patient groups, such as those who transfer to a hospital for sepsis treatment when the sepsis was diagnosed elsewhere.

Researchers set out to develop an algorithm that would allow for more precise tracking of pediatric sepsis. The group partnered with the CHOP Research Institute’s Arcus Pediatric Knowledge Network, an integrated data science platform that links the clinical and research data of more than two million patients.

The team built the algorithm using data from suspected or confirmed sepsis cases seen at CHOP between September 1, 2017 and June 30, 2018. Researchers then validated the tool using suspected or confirmed sepsis cases seen at CHOP between July 1, 2018 and January 31, 2019.

After validating the algorithm, the team applied the tool to 832,550 patients seen at CHOP in an emergency department or inpatient visit between 2011 and 2018 to collect the epidemiology of sepsis at CHOP.

The results showed that among more than 200,000 hospital admissions over the study period, the incidence of sepsis was 2.8 percent. Additionally, the incidence of sepsis among all hospital encounters increased over time after controlling for age, sex, and race. Mortality was 6.7 percent and did not change over time, in contrast to claims-based sepsis data that shows mortality has trended downward over time.

The algorithm could help providers collect more accurate data about the incidence and outcomes of sepsis over time, leading to improved care and lower healthcare costs.

"We were able for the first time to have a consistent, objective, and unbiased definition of sepsis applied over a period of eight years, without having to rely on laborious and expensive manual chart review or claims data that suffer from variability across providers and time," said Scott Weiss, MD, MSCE, an attending physician in the pediatric intensive care unit at CHOP and first author of the study.

The team is working to refine the tool for use in other hospitals and health systems.

"This study is one example of how our program can partner with Arcus and the CHOP Research Institute to become a national leader in sepsis care," said Fran Balamuth, MD, PhD, Co-Director of CHOP's Center for Sepsis Excellence, Director of Research in the Emergency Department, and co-author of the paper.

"The next step will be to externally validate the algorithm across different hospitals to make sure that it is not just applicable to CHOP, but at other academic children's hospitals and community hospitals as well."