February 01, 2021 3:18 PM

Children’s Hospital Stay for Severe Sepsis Associated with Income Disparities

Early findings suggest that children from lower-income neighborhoods may endure longer hospital stays after sepsis, a life-threatening response to an infection.

hospital bed in blue ink on lined paper

Children from lower-income socioeconomic backgrounds may be at higher risk of longer hospital stays from life-threatening sepsis, a new study suggests.

The early findings, led by Michigan Medicine C.S. Mott Children’s Hospital, were presented at the Society of Critical Care Medicine’s annual Critical Care Congress.

More than 70,000 American children a year are hospitalized with severe sepsis, a dangerous response to an infection that can lead to organ damage and in some cases, death.

“This is among the first studies showing an association between socioeconomic status and pediatric sepsis outcomes,” says lead author Kayla Phelps, M.D., M.P.H., of Mott.

“Our findings further emphasize health disparities that impact outcomes for children with lower socioeconomic status compared to their wealthier peers.”

Researchers analyzed a nationally representative database that included 10,130 severe pediatric sepsis hospitalizations. They found an association between where a child lived with their hospital length of stay.

Phelps says further research is needed to explore factors behind the disparities but they may include differences between hospitals, care delivered and different reasons that may delay patients being able to go home after recovery.

Overall, 851 (8.4%) of severe sepsis patients died during hospitalization but the data didn’t show a relationship between socioeconomic backgrounds and risk of death. Phelps says further studies should examine differences in mortality for pediatric severe sepsis based on other measures of socioeconomic status.

Among adults with severe sepsis, socioeconomic status is associated with significant health disparities, including higher mortality and readmission rate.

In children, previous research has also shown an association between socioeconomic status and adverse health outcomes for other conditions, including bronchiolitis, asthma and neonatal bacterial infections.  

A previous Mott-led study also found that pediatric sepsis cases may be 12 times costlier than other childhood hospitalizations.

Phelps says the new preliminary data highlights the importance of addressing health disparities through public policy interventions.

“It’s important to provide accessible, culturally appropriate, affordable healthcare to all children,” she says.

“Hopefully future studies can narrow the geographic area further to better understand the impact of community level socioeconomic factors on pediatric sepsis and children’s health outcomes.”

Abstract Cited: “The Association of Socioeconomic Status and Pediatric Sepsis Outcomes.” The primary faculty mentor was Erin Carlton, M.D., a pediatric intensivist at Mott.