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Pediatric Infectious Disease Journal:
doi: 10.1097/01.inf.0000435502.36996.72
Original Studies

Prognostic Factors in Pediatric Sepsis Study, From the Spanish Society of Pediatric Intensive Care

Pérez, David Vila MD*; Jordan, Iolanda PhD*; Esteban, Elisabeth*; García-Soler, Patricia MD; Murga, Vega MD; Bonil, Vanesa MD§; Ortiz, Irene MD; Flores, Carlos MD; Bustinza, Amaya MD**; Cambra, Francisco Jose PhD*

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Abstract

Background:

Sepsis and septic shock represent up to 30% of admitted patients in pediatric intensive care units, with a mortality that can exceed 10%. The objective of this study is to determine the prognostic factors for mortality in sepsis.

Methods:

Multicenter prospective descriptive study with patients (aged 7 days to 18 years) admitted to the pediatric intensive care units for sepsis, between January 2011 and April 2012.

Results:

Data from 136 patients were collected. Eighty-seven were male (63.9%). The median age was a year and a half (P25-75 0.3–5.5 years). In 41 cases (30.1%), there were underlying diseases. The most common etiology was Neisseria meningitidis (31 cases, 22.8%) followed by Streptococcus pneumoniae (16 patients, 11.8%). Seventeen cases were fatal (12.5%). In the statistical analysis, the factors associated with mortality were nosocomial infection (P = 0.004), hypotension (P <0.001) and heart and kidney failure (P < 0.001 and P = 0.004, respectively). The numbers of leukocytes, neutrophils and platelets on admission were statistically lower in the group that died (P was 0.006, 0.013 and <0.001, respectively). Multivariate analysis showed that multiple organ failure, neutropenia, purpura or coagulopathy and nosocomial infection were independent risk factors for increased mortality (odds ratio: 17, 4.9, 9 and 9.2, respectively).

Conclusions:

Patients with sepsis and multiorgan failure, especially those with nosocomial infection or the presence of neutropenia or purpura, have a worse prognosis and should be monitored and treated early.

Copyright © 2013 by Lippincott Williams & Wilkins

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