Sarmin Monira, Afroze Farzana, Alam Tahmina, Shaly Nusrat Jahan, Ahmed Tahmeed, Chisti Mohammod Jobayer
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Glob Pediatr Health. 2019 Jul 22;6:2333794X19862716. doi: 10.1177/2333794X19862716. eCollection 2019.
We aimed to identify clinical predictors of fatal outcome in children under 5 years of age having diarrhea and severe sepsis and treated in the Intensive Care Unit of the Dhaka Hospital of icddr,b from October 2010 through September 2011. Among 191 enrolled children, 70 (37%) died and were considered to be cases, while the remaining 121 (63%) who survived constituted the controls. The cases more often had shortness of breath (SOB), septic shock, dehydrating diarrhea compared with the controls (for all, < .05). After adjusting for potential confounders using logistic regression analysis, the likelihood of death was higher in children who had septic shock and SOB and lower in children having dehydrating diarrhea (for all, < .05). Thus, SOB can trigger an early alarm for sepsis recognition; otherwise, these children can end up with fatality from septic shock. In resource-poor settings, early identification of these predictors can alleviate death.
我们旨在确定2010年10月至2011年9月期间在达卡医院国际腹泻病研究中心孟加拉国分院重症监护病房接受治疗的5岁以下腹泻并患有严重脓毒症儿童死亡结局的临床预测因素。在191名登记入组的儿童中,70名(37%)死亡,被视为病例组,其余121名(63%)存活儿童构成对照组。与对照组相比,病例组更常出现呼吸急促、感染性休克和脱水性腹泻(所有P值均<0.05)。使用逻辑回归分析对潜在混杂因素进行校正后,患有感染性休克和呼吸急促的儿童死亡可能性更高,而患有脱水性腹泻的儿童死亡可能性更低(所有P值均<0.05)。因此,呼吸急促可引发脓毒症识别的早期警报;否则,这些儿童最终可能死于感染性休克。在资源匮乏地区,尽早识别这些预测因素可减少死亡。