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

ABSTRACT

AIM: The 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. METHODS: We 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. RESULTS: Substantially 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. CONCLUSIONS: There 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.