{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:18:36Z","timestamp":1792441116177,"version":"4.5.0"},"reference-count":48,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"abstract":"\n Importance<\/jats:title>\n Children commonly experience physical, cognitive, or emotional sequelae after sepsis. However, little is known about the development or progression of medical conditions after pediatric sepsis.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To quantify the development and progression of 4 common conditions in the 6 months after sepsis and to assess whether they differed after hospitalization for sepsis vs nonsepsis among critically ill children.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study of 101\u202f511 children (&amp;lt;19 years) with sepsis or nonsepsis hospitalization used a national administrative claims database (January 1, 2010, to June 30, 2018). Data management and analysis were conducted from April 1, 2020, to July 7, 2022.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Intensive care unit hospitalization for sepsis vs all-cause intensive care unit hospitalizations, excluding sepsis.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes were the development of 4 target conditions (chronic respiratory failure, seizure disorder, supplemental nutritional dependence, and chronic kidney disease) within 6 months of hospital discharge. Secondary outcomes were the progression of the 4 target conditions among children with the condition before hospitalization. Outcomes were identified via diagnostic and procedural codes, durable medical equipment codes, and prescription medications. Differences in the development and the progression of conditions between pediatric patients with sepsis and pediatric patients with nonsepsis who survived intensive care unit hospitalization were assessed using logistic regression with matching weights.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 5150 survivors of pediatric sepsis and 96\u202f361 survivors of nonsepsis intensive care unit hospitalizations were identified; 2593 (50.3%) were female. The median age was 9.5 years (IQR, 3-15 years) in the sepsis cohort and 7 years (IQR, 2-13 years) in the nonsepsis cohort. Of the 5150 sepsis survivors, 670 (13.0%) developed a new target condition, and 385 of 1834 (21.0%) with a preexisting target condition had disease progression. A total of 998 of the 5150 survivors (19.4%) had development and\/or progression of at least 1 condition. New conditions were more common among sepsis vs nonsepsis hospitalizations (new chronic respiratory failure: 4.6% vs 1.9%; odds ratio [OR], 2.54 [95% CI, 2.19-2.94]; new supplemental nutritional dependence: 7.9% vs 2.7%; OR, 3.17 [95% CI, 2.80-3.59]; and new chronic kidney disease: 1.1% vs 0.6%; OR, 1.65 [95% CI, 1.25-2.19]). New seizure disorder was less common (4.6% vs 6.0%; OR, 0.77 [95% CI, 0.66-0.89]). Progressive supplemental nutritional dependence was more common (1.5% vs 0.5%; OR, 2.95 [95% CI, 1.60-5.42]), progressive epilepsy was less common (33.7% vs 40.6%; OR, 0.74 [95% CI, 0.65-0.86]), and progressive respiratory failure (4.4% vs 3.3%; OR, 1.35 [95% CI, 0.89-2.04]) and progressive chronic kidney disease (7.9% vs 9.2%; OR, 0.84 [95% CI, 0.18-3.91]) were similar among survivors of sepsis vs nonsepsis admitted to an intensive care unit.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this national cohort of critically ill children who survived sepsis, 1 in 5 developed or had progression of a condition of interest after sepsis hospitalization, suggesting survivors of pediatric sepsis may benefit from structured follow-up to identify and treat new or worsening medical comorbid conditions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamapediatrics.2022.3554","type":"journal-article","created":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T11:19:33Z","timestamp":1665400773000},"page":"e223554","source":"Crossref","is-referenced-by-count":30,"title":["New and Progressive Medical Conditions After Pediatric Sepsis Hospitalization Requiring Critical Care"],"prefix":"10.1001","volume":"176","author":[{"given":"Erin F.","family":"Carlton","sequence":"first","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor"},{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Acham","family":"Gebremariam","sequence":"additional","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline B.","family":"Maddux","sequence":"additional","affiliation":[{"name":"Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine, Children\u2019s Hospital Colorado, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"McNamara","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Barbaro","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor"},{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy T.","family":"Cornell","sequence":"additional","affiliation":[{"name":"Lucille Packard Children\u2019s Hospital, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore J.","family":"Iwashyna","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, HSR&D Center of Innovation, Ann Arbor, Michigan"},{"name":"Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Prosser","sequence":"additional","affiliation":[{"name":"Susan B. Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Hospital, Harborview Medical Center, University of Washington School of Medicine, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Children\u2019s Hospital of Philadelphia, Pediatric Sepsis Program, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hallie C.","family":"Prescott","sequence":"additional","affiliation":[{"name":"VA Center for Clinical Management Research, HSR&D Center of Innovation, Ann Arbor, Michigan"},{"name":"Division of Pulmonary and Critical Care, Department of Internal Medicine, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"issue":"10","key":"poi220056r1","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1001\/jamapediatrics.2019.2570","article-title":"Cost of pediatric severe sepsis hospitalizations.","volume":"173","author":"Carlton","year":"2019","journal-title":"JAMA Pediatr"},{"issue":"7","key":"poi220056r2","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1097\/PCC.0b013e3182917fad","article-title":"Trends in the epidemiology of pediatric severe sepsis.","volume":"14","author":"Hartman","year":"2013","journal-title":"Pediatr Crit Care Med"},{"issue":"3","key":"poi220056r3","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1097\/CCM.0000000000004122","article-title":"Critical illness factors associated with long-term mortality and health-related quality of life morbidity following community-acquired pediatric septic shock.","volume":"48","author":"Zimmerman","year":"2020","journal-title":"Crit Care Med"},{"issue":"6","key":"poi220056r4","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1097\/PCC.0000000000001886","article-title":"Health-related quality of life among survivors of pediatric sepsis.","volume":"20","author":"Killien","year":"2019","journal-title":"Pediatr Crit Care Med"},{"issue":"3","key":"poi220056r5","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1097\/CCM.0000000000004123","article-title":"Trajectory of mortality and health-related quality of life morbidity following community-acquired pediatric septic shock.","volume":"48","author":"Zimmerman","year":"2020","journal-title":"Crit Care Med"},{"issue":"3","key":"poi220056r6","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1542\/peds.2008-0856","article-title":"Readmission and late mortality after pediatric severe sepsis.","volume":"123","author":"Czaja","year":"2009","journal-title":"Pediatrics"},{"issue":"4","key":"poi220056r7","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1097\/CCM.0000000000003646","article-title":"Readmission diagnoses after pediatric severe sepsis hospitalization.","volume":"47","author":"Carlton","year":"2019","journal-title":"Crit Care Med"},{"issue":"9","key":"poi220056r8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.15214","article-title":"Comparison of outpatient health care use before and after pediatric severe sepsis.","volume":"3","author":"Carlton","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"1","key":"poi220056r9","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1001\/jama.2017.17687","article-title":"Enhancing recovery from sepsis: a review.","volume":"319","author":"Prescott","year":"2018","journal-title":"JAMA"},{"issue":"14","key":"poi220056r10","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.1212\/WNL.0000000000004538","article-title":"Long-term risk of seizures in adult survivors of sepsis.","volume":"89","author":"Reznik","year":"2017","journal-title":"Neurology"},{"issue":"2","key":"poi220056r11","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1164\/rccm.201510-2023OC","article-title":"Long-term mortality and major adverse cardiovascular events in sepsis survivors: a nationwide population-based study.","volume":"194","author":"Ou","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"poi220056r12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2020.103044","article-title":"Exploring the pathophysiology of post-sepsis syndrome to identify therapeutic opportunities.","volume":"61","author":"van der Slikke","year":"2020","journal-title":"EBioMedicine"},{"issue":"9","key":"poi220056r13","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1164\/rccm.201307-1321OC","article-title":"Risk of cardiovascular events in survivors of severe sepsis.","volume":"189","author":"Yende","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"poi220056r14","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/j.xkme.2021.02.007","article-title":"Sepsis-associated acute kidney disease and long-term kidney outcomes.","volume":"3","author":"Flannery","year":"2021","journal-title":"Kidney Med"},{"issue":"5","key":"poi220056r15","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1186\/s13054-014-0469-1","article-title":"Effects of intra-abdominal sepsis on atherosclerosis in mice.","volume":"18","author":"Kaynar","year":"2014","journal-title":"Crit Care"},{"issue":"1","key":"poi220056r16","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1186\/s12885-018-4173-4","article-title":"Sepsis increases perioperative metastases in a murine model.","volume":"18","author":"Tai","year":"2018","journal-title":"BMC Cancer"},{"issue":"11","key":"poi220056r17","doi-asserted-by":"publisher","first-page":"3085","DOI":"10.1007\/s00405-014-3148-6","article-title":"Acute and long-term dysphagia in critically ill patients with severe sepsis: results of a prospective controlled observational study.","volume":"271","author":"Zielske","year":"2014","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"5","key":"poi220056r19","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1097\/01.CCM.0000261890.41311.E9","article-title":"Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003.","volume":"35","author":"Dombrovskiy","year":"2007","journal-title":"Crit Care Med"},{"issue":"1","key":"poi220056r20","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.ogc.2012.11.007","article-title":"Maternal sepsis.","volume":"40","author":"Morgan","year":"2013","journal-title":"Obstet Gynecol Clin North Am"},{"issue":"5","key":"poi220056r21","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1164\/rccm.200207-682OC","article-title":"The epidemiology of severe sepsis in children in the United States.","volume":"167","author":"Watson","year":"2003","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"poi220056r22","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1097\/MOP.0000000000000315","article-title":"Defining neonatal sepsis.","volume":"28","author":"Wynn","year":"2016","journal-title":"Curr Opin Pediatr"},{"issue":"7","key":"poi220056r24","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1097\/00003246-200107000-00002","article-title":"Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care.","volume":"29","author":"Angus","year":"2001","journal-title":"Crit Care Med"},{"issue":"36","key":"poi220056r25","doi-asserted-by":"publisher","first-page":"E1070","DOI":"10.1503\/cmaj.171382","article-title":"Renal complications and subsequent mortality in acute critically ill patients without pre-existing renal disease.","volume":"190","author":"Huang","year":"2018","journal-title":"CMAJ"},{"issue":"8","key":"poi220056r26","doi-asserted-by":"publisher","first-page":"e324","DOI":"10.1097\/PCC.0000000000000844","article-title":"Children and young adults who received tracheostomies or were initiated on long-term ventilation in PICUs.","volume":"17","author":"Edwards","year":"2016","journal-title":"Pediatr Crit Care Med"},{"issue":"6","key":"poi220056r27","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s00134-014-3298-4","article-title":"Use of tracheostomy in the PICU among patients requiring prolonged mechanical ventilation.","volume":"40","author":"Wakeham","year":"2014","journal-title":"Intensive Care Med"},{"issue":"1","key":"poi220056r28","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1186\/s13054-016-1409-z","article-title":"Long-term outcome in ICU patients with acute kidney injury treated with renal replacement therapy: a prospective cohort study.","volume":"20","author":"De Corte","year":"2016","journal-title":"Crit Care"},{"issue":"4","key":"poi220056r29","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1053\/j.ajkd.2011.10.048","article-title":"Long-term risk of CKD in children surviving episodes of acute kidney injury in the intensive care unit: a prospective cohort study.","volume":"59","author":"Mammen","year":"2012","journal-title":"Am J Kidney Dis"},{"key":"poi220056r30","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1186\/1471-2431-14-199","article-title":"Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.","volume":"14","author":"Feudtner","year":"2014","journal-title":"BMC Pediatr"},{"key":"poi220056r31","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1177\/1536867X0900900402","article-title":"cem: Coarsened exact matching in Stata.","volume":"9","author":"Blackwell","year":"2009","journal-title":"Stata J"},{"issue":"4","key":"poi220056r32","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/S0895-4356(00)00321-8","article-title":"Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: a matched analysis using propensity scores.","volume":"54","author":"Normand","year":"2001","journal-title":"J Clin Epidemiol"},{"issue":"3","key":"poi220056r33","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies.","volume":"46","author":"Austin","year":"2011","journal-title":"Multivariate Behav Res"},{"issue":"6","key":"poi220056r34","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1001\/jama.2018.21554","article-title":"Using the E-value to assess the potential effect of unmeasured confounding in observational studies.","volume":"321","author":"Haneuse","year":"2019","journal-title":"JAMA"},{"issue":"6","key":"poi220056r35","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1177\/0883073815620676","article-title":"Estimating epilepsy incidence and prevalence in the US pediatric population using nationwide health insurance claims data.","volume":"31","author":"Kim","year":"2016","journal-title":"J Child Neurol"},{"issue":"7","key":"poi220056r36","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1097\/PCC.0000000000001173","article-title":"High frequency of neuroimaging abnormalities among pediatric patients with sepsis who undergo neuroimaging.","volume":"18","author":"Sandquist","year":"2017","journal-title":"Pediatr Crit Care Med"},{"issue":"4","key":"poi220056r37","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/j.molmed.2014.02.005","article-title":"Interplay between sepsis and chronic health.","volume":"20","author":"Yende","year":"2014","journal-title":"Trends Mol Med"},{"key":"poi220056r38","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1016\/j.jpeds.2018.03.056","article-title":"Children with chronic disease bear the highest burden of pediatric sepsis.","volume":"199","author":"Prout","year":"2018","journal-title":"J Pediatr"},{"issue":"10","key":"poi220056r39","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1164\/rccm.201412-2323OC","article-title":"Global epidemiology of pediatric severe sepsis: the Sepsis Prevalence, Outcomes, and Therapies study.","volume":"191","author":"Weiss","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"issue":"10","key":"poi220056r40","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1001\/jama.2015.1410","article-title":"Readmission diagnoses after hospitalization for severe sepsis and other acute medical conditions.","volume":"313","author":"Prescott","year":"2015","journal-title":"JAMA"},{"key":"poi220056r41","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002932","author":"Maddux","year":"2022","journal-title":"Pediatr Crit Care Med"},{"key":"poi220056r42","doi-asserted-by":"publisher","journal-title":"Crit Care Med","DOI":"10.1097\/CCM.0000000000004272"},{"issue":"11","key":"poi220056r43","doi-asserted-by":"publisher","first-page":"e1063","DOI":"10.1097\/CCM.0000000000005337","article-title":"Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021.","volume":"49","author":"Evans","year":"2021","journal-title":"Crit Care Med"},{"key":"poi220056r44","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.691692","article-title":"Implementation of a follow-up system for pediatric sepsis survivors in a large academic pediatric intensive care unit.","volume":"9","author":"Fitzgerald","year":"2021","journal-title":"Front Pediatr"},{"issue":"3","key":"poi220056r45","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1097\/CCM.0000000000005300","article-title":"Effect of a multicomponent sepsis transition and recovery program on mortality and readmissions after sepsis: the Improving Morbidity During Post-Acute Care Transitions for Sepsis randomized clinical trial.","volume":"50","author":"Taylor","year":"2022","journal-title":"Crit Care Med"},{"issue":"1","key":"poi220056r46","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1097\/PCC.0000000000000538","article-title":"ICU-acquired weakness is associated with differences in clinical outcomes in critically ill children.","volume":"17","author":"Field-Ridley","year":"2016","journal-title":"Pediatr Crit Care Med"},{"issue":"11","key":"poi220056r47","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1164\/rccm.201708-1768OC","article-title":"Long-term outcomes after protocolized sedation versus usual care in ventilated pediatric patients.","volume":"197","author":"Watson","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"poi220056r48","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005426","author":"Rudolph","year":"2022","journal-title":"Crit Care Med"},{"key":"poi220056r18","unstructured":"Truven Health Analytics. Commercial claims and encounters Medicare supplement. Accessed June 18, 2020. https:\/\/theclearcenter.org\/wp-content\/uploads\/2020\/01\/IBM-MarketScan-User-Guide.pdf"},{"key":"poi220056r23","unstructured":"Grider? D. Revisiting neonatal and pediatric critical care services. Society of Critical Care Medicine. Accessed May 22, 2022. https:\/\/sccm.org\/Communications\/Critical-Connections\/Archives\/2019\/Revisiting-Neonatal-and-Pediatric-Critical-Care-Se"}],"container-title":["JAMA Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/articlepdf\/2797249\/jamapediatrics_carlton_2022_oi_220056_1667596393.07801.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T13:02:11Z","timestamp":1701176531000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/fullarticle\/2797249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,7]]},"references-count":48,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapediatrics.2022.3554","relation":{},"ISSN":["2168-6203"],"issn-type":[{"value":"2168-6203","type":"print"}],"subject":[],"published":{"date-parts":[[2022,11,7]]}}}