Réka Szigeti, Noémi Balázs, Réka Bikfalvi, Róbert Urbán
Burnout and depressive symptoms in teachers: Factor structure and construct validity of the Maslach Burnout inventory-educators survey among elementary and secondary school teachers in Hungary
Stress and health : journal of the International Society for the Investigation of Stress
sepsis major cause child mortality morbidity enhance outcomes children severe sepsis septic shock often require escalated care organ support sometimes necessitating interhospital transfer association transfer admission care pediatric severe sepsis septic shock inhospital patient survival resource use poorly understood retrospective study children 020 years old hospitalized severe sepsis septic shock using 2012 kids inpatient database descriptive bivariate analysis multivariate regression methods assessed independent relationship transfer status outcomes inhospital mortality duration hospitalization hospital charges adjustment potential confounders including illness severity estimated 11922 hospitalizations transfer information pediatric severe sepsis septic shock nationally 2012 25 transferred often urban teaching hospitals compared nontransferred children transferred children younger higher frequency extreme illness severity 84 vs 75 p 01 multiple organ dysfunction 32 vs 24 p 01 also higher use invasive medical devices including arterial catheters invasive mechanical ventilation central venous catheters specialized technology including renal replacement therapy 62 vs 46 p 01 extracorporeal membrane oxygenation 57 vs 18 p 01 transferred children longer hospitalization accrued higher charges nontransferred children p 01 crude mortality higher among transferred nontransferred children 214 vs150 p 01 difference longer statistically significant multivariate adjustment potential confounders odds ratio104 95 confidence interval 088124 similarly adjusted length hospital stay hospital charges statistically different transfer status one four children severe sepsis septic shock required interhospital transfer specialized care associated greater use invasive medical devices specialized technology despite higher crude mortality resource consumption among transferred children adjusted mortality resource use differ transfer status research identify qualityofcare factors receiving hospitals influence clinical outcomes resource use