Department of Child Health, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
J Trop Pediatr. 2023 Sep 7;69(5). doi: 10.1093/tropej/fmad029.
This study aimed to explore the factors contributing to mortality and its management among pediatric sepsis patients at a single center in Indonesia.
We conducted a retrospective study of children admitted due to sepsis from January 2015 to December 2019 in an Indonesian tertiary hospital.
The mortality rate of pediatric sepsis in our study was 76.1% among 176 records with outcome identified. Mortality was significantly associated with septic shock at triage, number of organ failure, intensive care unit admission, inotropic use, septic shock and severe sepsis during hospitalization. Timing of antibiotic use did not affect mortality. Death within the first 24 h occurred in 41.8% of subjects, mostly due to septic shock.
This study illuminates the current state of pediatric sepsis management in our Indonesian hospital, revealing it as inadequate. Findings highlight the need for improved pre-hospital systems and sepsis recognition tools, and wider use of mechanical ventilators and advanced monitoring due to limited pediatric intensive care unit beds. Future research should focus on hospital-specific sepsis protocols to reduce pediatric sepsis mortality rates.
本研究旨在探讨印度尼西亚某单一中心儿科脓毒症患者死亡的相关因素及其管理。
我们对 2015 年 1 月至 2019 年 12 月期间在印度尼西亚一所三级医院因脓毒症住院的儿童进行了回顾性研究。
在确定结局的 176 份记录中，本研究中儿科脓毒症的死亡率为 76.1%。死亡与分诊时出现脓毒性休克、器官衰竭数量、入住重症监护病房、使用正性肌力药、住院期间出现脓毒性休克和严重脓毒症显著相关。抗生素使用时机并不影响死亡率。41.8%的患者在 24 小时内死亡，主要原因是脓毒性休克。
本研究阐明了印度尼西亚医院儿科脓毒症管理的现状，发现其存在不足。研究结果强调需要改善院前系统和脓毒症识别工具，并因儿科重症监护病房床位有限而更广泛地使用机械呼吸机和先进的监测设备。未来的研究应集中在医院特定的脓毒症方案上，以降低儿科脓毒症的死亡率。
