{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:36:30Z","timestamp":1778870190012,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T00:00:00Z","timestamp":1518134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Taiwan National Ministry of Science and Technology Grants","award":["MOST 104-2314-B-002-039-MY3"],"award-info":[{"award-number":["MOST 104-2314-B-002-039-MY3"]}]},{"name":"Taiwan National Ministry of Science and Technology Grants","award":["MOST 106-2811-B-002-048"],"award-info":[{"award-number":["MOST 106-2811-B-002-048"]}]},{"name":"Far Eastern Memorial Hospital Grant","award":["FEMH-2016-C-028"],"award-info":[{"award-number":["FEMH-2016-C-028"]}]},{"name":"Taiwan National Science Foundation Grant","award":["NSC 102-2314-B-002-131-MY3"],"award-info":[{"award-number":["NSC 102-2314-B-002-131-MY3"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to investigate the trend of incidence and outcome of paediatric sepsis in a population\u2010based database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children with sepsis were identified from the 23 million nationwide health insurance claims database of Taiwan. Sepsis was defined by the presence of single ICD\u20109 code for severe sepsis or septic shock or a combination of ICD\u20109 codes for infection and organ dysfunction. We analysed the trend of incidence, mortality and source of infection in three age groups: infant (28 days to 1 year), child (1\u20139 years) and adolescent (10\u201318 years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2002 to 2012, we identified 38 582 paediatric patients with sepsis, of which 21.3% were infants, 52.8% were children and 25.8% were adolescents. The incidence of sepsis was 336.4 cases per 100 000 population in infants, 3.3 times higher than in children (101.5\/100 000 cases) and 7.3 times higher than in adolescents (46.2\/100 000 cases). While sepsis incidence decreased from 598.0 to 336.4 cases per 100 000 people in the infant population, it remained relatively unchanged in children and adolescents. For 90\u2010day mortality, there were significant decreases in all three age groups (absolute decrease of 5.0% for infants, 3.7% for children and 14.4% for the adolescents). In the infant population, we observed a decrease in the incidence of lower respiratory tract infections, while the incidence of urinary tract infections remained unchanged.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence and mortality of sepsis among paediatric patients have decreased substantially between 2002 and 2012, especially among infants. The widespread use of <jats:italic>Haemophilus influenzae<\/jats:italic> and pneumococcal vaccines in infants could be a possible explanation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.13849","type":"journal-article","created":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T07:22:44Z","timestamp":1518160964000},"page":"776-783","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Trend and outcome of sepsis in children: A nationwide cohort study"],"prefix":"10.1111","volume":"54","author":[{"given":"Chia\u2010Hung","family":"Yo","sequence":"first","affiliation":[{"name":"Department of Pediatric Emergency Medicine Far Eastern Memorial Hospital  New Taipei City Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu\u2010Chun","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng\u2010Tse","family":"Gabriel Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Porta","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital University of Milan  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po\u2010Yang","family":"Tsou","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Hsun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan\u2010Chien","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Szu\u2010Ta","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Taiwan University Hospital Yun\u2010Lin Branch  Yunlin County Taiwan"},{"name":"Department of Pediatrics National Taiwan University Children's Hospital  Taipei Taiwan"},{"name":"Graduate Institute of Toxicology, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien\u2010Chang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Taiwan University Hospital  Taipei Taiwan"},{"name":"Department of Emergency Medicine and Department of General Medicine National Taiwan University Hospital Yun\u2010Lin Branch  Yunlin County Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of National Taiwan University Hospital Health Economics and Outcome Research Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.0250"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.4276"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61682-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3182917fad"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200207-682OC"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000161289.22464.C3"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201504-0781OC"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-014-0717-7"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000026"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31827c09f8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000254"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200107000-00002"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0378-3782(86)90060-5"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2174\/1875041901104010004"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000225"},{"key":"e_1_2_9_17_1","first-page":"893","article-title":"Direct and indirect effects of routine vaccination of children with 7\u2010valent pneumococcal conjugate vaccine on incidence of invasive pneumococcal disease \u2013 United States, 1998\u20132003","volume":"54","author":"Centers for Disease Control and Prevention","year":"2005","journal-title":"MMWR Morb. 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