Paediatric anaesthesia & critical care
National Estimates of Pediatric Sepsis in US Hospitals Using Clinical Data
An erratum to this article was published (JAMA, 23 Jun 2026 ↗)
Authors' conclusion
An EHR-based definition for pediatric sepsis demonstrated strong validity compared with physician-adjudicated Phoenix sepsis and identified sepsis in 1.3% of pediatric hospitalizations with 10% mortality, corresponding to more than 18 000 cases and more than 1800 deaths annually in the US.
Study context
- Population
- US pediatric hospitalizations (age >30 days to 17 years), Epic Cosmos (245 health care systems, 2016–2023) and HCA Healthcare (146 hospitals, 2018–2023)
- Participants
- 3,925,809 pediatric hospitalizations
- Exposure
- Pediatric Sepsis Event (PSE) vs Administrative codes
- Outcome
- Sepsis incidence, characteristics, and in-hospital mortality
Methodological details2 electronic health record (EHR) datasets, medical record review validation, multicentre
- 2 EHR datasets
- Medical record review validation
- Multicentre
Main finding
As reported in the abstract
Sepsis incidence and in-hospital mortality
- Sepsis cases identified
- 51 542
- Sepsis incidence
- 1.3%
- Community onset
- 37 405 (72.6%)
- Septic shock
- 31 744 (61.6%)
- In-hospital mortality
- 10.1%
- Sepsis present in hospitalizations that culminated in death
- 17.8%
- Mean age of sepsis cases, years
- 6.6 [SD, 6.0]
- Female
- 22 840 [44.3%]
Observational data: associations, not effects.
Further findings
| Outcome | PSE |
|---|---|
| Validity vs physician-adjudicated Phoenix sepsis (medical record review) | |
| Sensitivity | 69.9% (95% CI, 58.1%-79.8%) |
| Specificity | 93.1% (95% CI, 89.6%-95.7%) |
- Validity vs physician-adjudicated Phoenix sepsis (medical record review): 581 high-risk encounters at 3 hospitals
Validity vs physician-adjudicated Phoenix sepsis (medical record review)
- PSE had higher sensitivity than and comparable specificity with administrative codes
National estimates, 2022
- Sepsis cases
- 18 231 (95% CI, 16 129-20 334)
- Deaths
- 1877 (95% CI, 1629-2126)
Temporal trends 2016-2022 (annual change)
- Sepsis cases, annual change
- 0.2% [95% CI, −2.2% to 2.7%]
- Deaths, annual change
- 0.3% [95% CI, −3.1% to 3.8%]
- Neither changed significantly
Secondary datasets
- Incidence, characteristics, and mortality broadly consistent across secondary datasets
Original publication
National Estimates of Pediatric Sepsis in US Hospitals Using Clinical Data. JAMA. Published 21 April 2026. doi:10.
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