Abstract
Objective
To determine the epidemiology and outcome of sepsis in children admitted in pediatric intensive care unit (PICU) of a tertiary care hospital.
Methods
Retrospective review of children 1 mo to 14 y old, admitted to the PICU with severe sepsis or septic shock from January 2007 through December 2008 was done. Demographic, clinical and laboratory features of subjects were reviewed. The primary outcome was mortality at the time of discharge from PICU. The independent predictors of mortality were modeled using multiple logistic regression.
Results
In 2 years, 17.3% (133/767) children admitted to the PICU had sepsis. Median age was 18 mo (IQR 6–93 mo), with male: female ratio of 1.6:1. Mean PRISM III score was 9 (±7.8). One third had culture proven infection, majority (20%) having bloodstream infection. The frequency of multi-organ dysfunction syndrome (MODS) was 81% (108/133). The case specific mortality rate of sepsis was 24% (32/133). Multi-organ dysfunction (Adjusted OR 18.0, 95% CI 2.2–144), prism score of >10 (Adjusted OR 1.5, 95% CI 0.6–4.0) and the need for > 2 inotropes (Adjusted OR 3.5, 95% CI 1.3–9.2) were independently associated with mortality due to sepsis.
Conclusions
The presence of septic shock and MODS is associated with high mortality in the PICU of developing countries.
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Conflict of Interest and Role of Funding Source
Dr Farah Naz Qamar, received research training support from the National Institute of Health’s Fogarty International Center (1 D43 TW007585-01). The sponsors did not have any role in study design, data analysis or report writing.
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Khan, M.R., Maheshwari, P.K., Masood, K. et al. Epidemiology and Outcome of Sepsis in a Tertiary Care PICU of Pakistan. Indian J Pediatr 79, 1454–1458 (2012). https://doi.org/10.1007/s12098-012-0706-z
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DOI: https://doi.org/10.1007/s12098-012-0706-z