Reporting of Social Determinants of Health in Pediatric Sepsis Studies.

Kusum Menon, Lauren R Sorce, Andrew Argent, Tellen D Bennett, Enitan D Carrol, Niranjan Kissoon, L Nelson Sanchez-Pinto, Luregn J Schlapbach, Daniela C de Souza, R Scott Watson, James L Wynn, Jerry J Zimmerman, Suchitra Ranjit

Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies 2023;24(4):301-310

PMID: 36696549

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Abstract

OBJECTIVE

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.

DATA SOURCES AND SELECTION

We reviewed 106 articles (published between 2005 and 2020) utilized in a recent systematic review on physiologic criteria for pediatric sepsis.

DATA EXTRACTION

Data were extracted by two reviewers on variables that fell within the World Health Organization's SDOH categories.

DATA SYNTHESIS

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.

CONCLUSIONS

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.

Address: Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.; Ann & Robert H. Lurie Children's Hospital AND Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa.; Sections of Informatics and Data Science and Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO.; Department of Clinical Infection Microbiology and Immunology, University of Liverpool Institute of Infection, Veterinary and Ecological Sciences, Liverpool, United Kingdom.; British Columbia Children's Hospital and The University of British Columbia, Vancouver, BC, Canada.; Division of Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.; Department of Intensive Care and Neonatology, Children`s Research Center University Children's Hospital Zurich, Zurich, Switzerland.; Child Health Research Centre, The University of Queensland, St Lucia, QLD, Australia.; Departments of Pediatrics, Hospital Sírio-Libanês and Hospital Universitário da Universidade de São Paulo, São Paolo, Brazil.; Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.; Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Florida, Gainesville, FL.

DOI: 10.1097/PCC.0000000000003184

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MeSH Terms: Humans, Child, Social Determinants of Health, Socioeconomic Factors, Sepsis