Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
Clinical Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
BMC Pediatr. 2021 Oct 25;21(1):471. doi: 10.1186/s12887-021-02945-0.
Sepsis is the leading cause of death worldwide in pediatric populations. Studies in low-resource settings showed that the majority of pediatric patients with sepsis still have a high mortality rate.
We retrospectively collected records from 2014 to 2019 of patients who had been diagnosed with sepsis and admitted to PICU in our tertiary hospital. Cox proportional hazard regression modeling was used to evaluate associations between patient characteristics and mortality.
Overall, 665 patients were enrolled in this study, with 364 (54.7%) boys and 301 (46.3%) girls. As many as 385 patients (57.9%) died during the study period. The median age of patients admitted to PICU were 1.8 years old with interquartile range (IQR) ±8.36 years and the median length of stay was 144 h (1-1896 h). More than half 391 patients (58.8%) had a good nutritional status. Higher risk of mortality in PICU was associated fluid overload percentage of > 10% (HR 9.6, 95% CI: 7.4-12.6), the need of mechanical ventilation support (HR 2.7, 95% CI: 1.6-4.6), vasoactive drugs (HR 1.5, 95% CI: 1.2-2.0) and the presence of congenital anomaly (HR 1.4, 95% CI: 1.0-1.9). On the contrary, cerebral palsy (HR 0.3, 95% CI: 0.1-0.5) and post-operative patients (HR 0.4, 95% CI: 0.3-0.6) had lower mortality.
PICU mortality in pediatric patients with sepsis is associated with fluid overload percentage of > 10%, the need for mechanical ventilation support, the need of vasoactive drugs, and the presence of congenital anomaly. In septic patients in PICU, those with cerebral palsy and admitted for post-operative care had better survival.
脓毒症是全球儿科人群死亡的主要原因。在资源匮乏的环境中进行的研究表明，大多数脓毒症儿科患者的死亡率仍然很高。
我们回顾性地收集了 2014 年至 2019 年期间在我们的三级医院重症监护病房（PICU）被诊断为脓毒症并住院的患者的记录。使用 Cox 比例风险回归模型评估患者特征与死亡率之间的关联。
共有 665 名患者入组本研究，其中 364 名（54.7%）为男孩，301 名（46.3%）为女孩。在研究期间，多达 385 名（57.9%）患者死亡。PICU 入院患者的中位年龄为 1.8 岁，四分位间距（IQR）为±8.36 岁，中位住院时间为 144 小时（1-1896 小时）。超过一半的 391 名（58.8%）患者营养状况良好。PICU 死亡率较高与液体超负荷百分比>10%（HR 9.6，95%CI：7.4-12.6）、需要机械通气支持（HR 2.7，95%CI：1.6-4.6）、血管活性药物（HR 1.5，95%CI：1.2-2.0）和先天性异常（HR 1.4，95%CI：1.0-1.9）有关。相反，脑瘫（HR 0.3，95%CI：0.1-0.5）和术后患者（HR 0.4，95%CI：0.3-0.6）死亡率较低。
脓毒症儿科患者 PICU 死亡率与液体超负荷百分比>10%、需要机械通气支持、需要血管活性药物和存在先天性异常有关。在 PICU 中患有脓毒症的患者中，患有脑瘫和接受术后治疗的患者生存率更高。
