Burden and distribution of mortality due to sepsis and severe infection in children and adolescents in Aotearoa/New Zealand

Abstract

AimThe aims of this research were to determine the mortality from sepsis and severe infection in the paediatric and adolescent populations of Aotearoa/New Zealand, and to determine the distribution of mortality by sub‐populations.MethodsWe used three different methods to identify deaths from sepsis and severe infection and compared the groups: All deaths primarily coded with any ICD‐10‐AM code relating to sepsis; The presence of A40, A41 and P36 in any cause of death field; Deaths due to pneumonia and meningitis. Cases were selected from a national mortality database, with cause of death as ascribed in the national mortality collection for the years 2002–2020 inclusive. Overall sepsis and severe infection rates were calculated from the sum of unique cases from all three methods for determining sepsis and severe infection cases.ResultsSubstantially different results were obtained depending on the method of identifying cases. In total, 577 deaths due to sepsis and severe infection were detected, with an overall rate of 1.99/100 000 age‐specific population and statistically significant disparity by ethnic grouping. Rates were highest in post‐neonatal infants at 22.7 per 100 000, regardless of the method of identification.ConclusionsThere is a considerable opportunity to improve the mortality from sepsis and severe infection in children and young people. The ethnic disparities described in this paper show the need to ensure a high level of care for those most marginalised in society through the development and provision of systems and structures that meet, rather than fail to meet need.