Reporting of Social Determinants of Health in Pediatric Sepsis Studies.

Standardized, consistent reporting of social determinants of health (SDOH) in studies on children with sepsis would allow for: 1) understanding the association of SDOH with illness severity and outcomes, 2) comparing populations and extrapolating study results, and 3) identification of potentially modifiable socioeconomic factors for policy makers. We, therefore, sought to determine how frequently data on SDOH were reported, which factors were collected and how these factors were defined in studies of sepsis in children. We reviewed 106 articles (published between 2005 and 2020) utilized in a recent systematic review on physiologic criteria for pediatric sepsis. Data were extracted by two reviewers on variables that fell within the World Health Organization's SDOH categories. SDOH were not the primary outcome in any of the included studies. Seventeen percent of articles (18/106) did not report on any SDOH, and a further 36.8% (39/106) only reported on gender/sex. Of the remaining 46.2% of articles, the most reported SDOH categories were preadmission nutritional status (35.8%, 38/106) and race/ethnicity (18.9%, 20/106). However, no two studies used the same definition of the variables reported within each of these categories. Six studies reported on socioeconomic status (3.8%, 6/106), including two from upper-middle-income and four from lower middle-income countries. Only three studies reported on parental education levels (2.8%, 3/106). No study reported on parental job security or structural conflict. We found overall low reporting of SDOH and marked variability in categorizations and definitions of SDOH variables. Consistent and standardized reporting of SDOH in pediatric sepsis studies is needed to understand the role these factors play in the development and severity of sepsis, to compare and extrapolate study results between settings and to implement policies aimed at improving socioeconomic conditions related to sepsis.

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Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

Déclaration de conflit d'intérêts

Dr. Menon is funded by Canadian Institutes of Health for a trial on hydrocortisone in pediatric septic shock. Drs. Bennett and Sanchez-Pinto are funded by the National Institutes of Health (NIH)/National Institute of Child Health and Human Development (NICHD) grant: R01HD105939-01. Dr. Carrol is a BioFire Diagnostics Scientific Advisory Board member for the FilmArray System, Surviving Sepsis Campaign Pediatrics Guideline panel member, and has National Institutes of Health and Care Research-funded research collaboration with Biomerieux. Dr. Wynn is funded by NIH grants for work on neonatal sepsis: GM128452, HD097081, and EB029863. Dr. Zimmerman is funded by NIH/NICHD for a sepsis interventional trial and Immunexpress for a sepsis prospective descriptive cohort investigation. Dr. Menon’s institution received funding from the Canadian Institutes of Health Research. Dr. Argent received funding from legal firms in South Africa and for travel and accommodation costs for conferences as a speaker. Drs. Bennett’s, Sanchez-Pinto’s, and Zimmerman’s institutions received funding from the NICHD. Dr. Bennett’s institution received funding from the National Center for Advancing Translational Sciences and the National Heart, Lung, and Blood Institute. Drs. Bennett, Sanchez-Pinto, and Wynn received support for article research from the NIH. Dr. Watson received funding from Society of Critical Care Medicine for a travel meeting. Dr. Wynn received funding from the American Academy of Pediatrics, Developmental Symposium, the NIH, and Roche Diagnostics. Dr. Zimmerman’s institution received funding from Immunexpress; he received funding from Elsevier Publishing. The remaining authors have disclosed that they do not have any potential conflicts of interest.