Novel Pediatric Sepsis Criteria and Clinical Decision Support Tools

University Of Colorado Denver, Aurora CO

Investigators

Linked publications, trials & patents

Abstract

PROJECT SUMMARY/ABSTRACT Pediatric sepsis is a major global public health problem associated with millions of deaths every year. In the United States, 1 in every 10-15 children with sepsis or septic shock will die during their hospitalization, and many survivors will have a lower health-related quality of life. We collaborated with an international task force to develop and validate the novel Phoenix criteria for sepsis and septic shock in children, which were published in two high-impact articles in JAMA and are now the reference standard for diagnosing pediatric sepsis around the world.8,9 The criteria are based on the Phoenix Sepsis Score (PSS), which we developed using a data- driven approach and >3.6 million patient records and include information for four organ dysfunctions. In order to maximize the impact of the Phoenix criteria for pediatric sepsis, several knowledge gaps must be addressed. In this study we will: evaluate the prognostic accuracy of the Phoenix sepsis criteria and the PSS before and after the COVID-19 pandemic and in the setting of specific organisms and infectious syndromes as well as varying vaccination status of at-risk children (SA 1); derive and validate sepsis trajectories based on the changes in the PSS over time that can help inform clinical decision-making (SA 2); prospectively validate the Phoenix sepsis criteria and the PSS overall and in high-risk patient subgroups (SA 3); and design and implement generalizable clinical workflows that maximize the impact of the Phoenix sepsis criteria and PSS trends (SA 4). We will leverage and expand our existing dataset by adding 2 new sites, 5 additional years of data from each site, and new data elements including vaccination records. We will also conduct a prospective study at four sites to validate the performance of the Phoenix criteria as CDS tools. We have enhanced our accomplished investigative team by adding new sites and expertise in human-computer interaction, CDS tool design, and pediatric hospital medicine. We expect the results of this proposal to have a powerful and sustained impact on the science of pediatric sepsis and ultimately improve sepsis recognition, accelerate appropriate effective treatment, decrease unnecessary treatment, and improve the outcomes of children with sepsis around the world.