Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 18 , ISSUE 7 ( July, 2014 ) > List of Articles

RESEARCH ARTICLE

Clinical outcome and predictors of mortality in children with sepsis, severe sepsis, and septic shock from Rohtak, Haryana: A prospective observational study

Gurpreet Kaur, Jaya Shankar Kaushik, Nikhil Vinayak, Mohammad Aamir

Keywords : Multiorgan dysfunction, pediatric risk of mortality scoring, sepsis, septic shock

Citation Information : Kaur G, Kaushik JS, Vinayak N, Aamir M. Clinical outcome and predictors of mortality in children with sepsis, severe sepsis, and septic shock from Rohtak, Haryana: A prospective observational study. Indian J Crit Care Med 2014; 18 (7):437-441.

DOI: 10.4103/0972-5229.136072

License: CC BY-ND 3.0

Published Online: 01-10-2006

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

Background: Information regarding early predictive factors for mortality and morbidity in sepsis is limited from developing countries. Methods: A prospective observational study was conducted to determine the clinical outcome and predictors of mortality in children with sepsis, severe sepsis, and septic shock. Children aged 1 month to 14 years admitted to a tertiary care pediatric intensive care unit (PICU) with a diagnosis of sepsis, severe sepsis, or septic shock were enrolled in the study. Hemodynamic and laboratory parameters which discriminate survivors from nonsurvivors were evaluated. Results: A total of 50 patients (30 [60%] males) were enrolled in the study, of whom 21 (42%) were discharged (survivors) and rest 29 (58%) expired (nonsurvivor). Median (interquartile range) age of enrolled patients were 18 (6, 60) months. Mortality was not significantly predicted individually by any factor including age (odds ratio [OR] [95% confidence interval [CI]]: 0.96 [0.91-1.01], P = 0.17), duration of PICU stay (OR [95% CI]: 1.18 [0.99-1.25], P = 0.054), time lag to PICU transfer (OR [95% CI]: 1.02 [0.93-1.12], P = 0.63), Pediatric Risk of Mortality (PRISM) score at admission (OR [95% CI]: 0.71 [0.47-1.04], P = 0.07) and number of organ dysfunction (OR [95% CI]: 0.03 [0.01-1.53], P = 0.08). Conclusion: Mortality among children with sepsis, severe sepsis, and septic shock were not predicted by any individual factors including the time lag to PICU transfer, duration of PICU stay, presence of multiorgan dysfunction, and PRISM score at admission.


PDF Share
  1. Carcillo JA. Reducing the global burden of sepsis in infants and children: A clinical practice research agenda. Pediatr Crit Care Med 2005;6:S157-64.
  2. Sarthi M, Lodha R, Vivekanandhan S, Arora NK. Adrenal status in children with septic shock using low-dose stimulation test. Pediatr Crit Care Med 2007;8:23-8.
  3. Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO child health epidemiology reference group. WHO estimates of the causes of death in children. Lancet 2005;365:1147-52.
  4. Pollack MM, Ruttimann UE, Getson PR. Accurate prediction of the outcome of pediatric intensive care. A new quantitative method. N Engl J Med 1987;316:134-9.
  5. Bertolini G, Ripamonti D, Cattaneo A, Apolone G. Pediatric risk of mortality: An assessment of its performance in a sample of 26 Italian intensive care units. Crit Care Med 1998;26:1427-32.
  6. Shrestha P, Mohan A, Sharma S, Guleria R, Vikram N, Wig N, etal. To Determine the Predictors of Mortality and Morbidity of Sepsis in Medical ICU of All India Institute of Medical Sciences (AIIMS). New Delhi, India: Chest; 2012. p. 142. Available from: Http://www journal.publications. chestnet.org/article.aspx?articleid=1376342#tab1. [Last accessed on 2013 June 13].
  7. Thukral A, Lodha R, Irshad M, Arora NK. Performance of Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality (PIM), and PIM2 in a pediatric intensive care unit in a developing country. Pediatr Crit Care Med 2006;7:356-61.
  8. Khan MR, Maheshwari PK, Masood K, Qamar FN, Haque AU. Epidemiology and outcome of sepsis in a tertiary care PICU of Pakistan. Indian J Pediatr 2012;79:1454-8.
  9. Singhal D, Kumar N, Puliyel JM, Singh SK, Srinivas V. Prediction of mortality by application of PRISM score in intensive care unit. Indian Pediatr 2001;38:714-9.
  10. Bellad R, Rao S, Patil VD, Mahantshetti NS. Outcome of intensive care unit patients using Pediatric Risk of Mortality (PRISM) score. Indian Pediatr 2009;46:1091-2.
  11. Khilnani P, Singhi S, Lodha R, Santhanam I, Sachdev A, Chugh K, et al. Pediatric Sepsis Guidelines: Summary for resource-limited countries. Indian J Crit Care Med 2010;14:41-52.
  12. Krishna U, Joshi SP, Modh M. An evaluation of serial blood lactate measurement as an early predictor of shock and its outcome in patients of trauma or sepsis. Indian J Crit Care Med 2009;13:66-73.
  13. Khilnani P, Sarma D, Zimmerman J. Epidemiology and peculiarities of pediatric multiple organ dysfunction syndrome in New Delhi, India. Intensive Care Med 2006;32:1856-62.
  14. Khilnani P, Sarma D, Singh R, Uttam R, Rajdev S, Makkar A, et al. Demographic profile and outcome analysis of a tertiary level pediatric intensive care unit. Indian J Pediatr 2004;71:587-91.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.