Center-level Resource Availability and Septic Shock Detection in Children with Leukemia and Other Tumors
Mentor: Dr. Alix Seif
Septic shock is a major cause of morbidity and mortality in children with acute leukemias. Early detection and aggressive treatment are crucial to successful management, and delays in delivering care can be deadly. Children who face barriers to accessing prompt medical evaluation and treatment have an outsized risk of experiencing these life-threatening complications and subsequent excess mortality. We are investigating how individual social factors, hospital practices, and genetics influence risks of septic shock in children being treated for leukemia.
A key component of this research is to study hospital factors that may contribute to delays in detecting and treating septic shock. We previously found hospitals with higher proportions of patients with public insurance have higher rates of induction mortality. Early detection and management of septic shock require adequate hospital resources, which may be decreased in hospitals with overall lower reimbursements due to payer mix. Implementing hospital-based initiatives to improve early detection and treatment could save lives of children undergoing cancer therapy.
We have collected data on 49 hospitals in the Pediatric Health Information System (PHIS) database on patient volumes, hospital demographics, and payer mix. We recently developed a new collaboration with the Children’s Hospital Association to use their PROSPECT database to evaluate hospital staffing, volume, and acuity by unit. This new data source needs to be documented and collated with data from PHIS and from the American Hospital Association (AHA). We will create a database to collect and organize hospital data from these sources (PHIS, PROSPECT, and AHA).
