TY - JOUR
T1 - Epidemiology and outcome of sepsis in a tertiary care PICU of Pakistan
AU - Khan, Muhammad Rehan
AU - Maheshwari, Prem Kumar
AU - Masood, Komal
AU - Qamar, Farah Naz
AU - Haque, Anwar Ul
N1 - Funding Information:
Qamar, received research training support from the National Institute of Health’s Fogarty International Center (1 D43 TW007585-01). The sponsors did not have any role in study design, data analysis or report writing.
PY - 2012/11
Y1 - 2012/11
N2 - Objective To determine the epidemiology and outcome of sepsis in children admitted in pediatric intensive care unit (PICU) of a tertiary care hospital. Methods Retrospective review of children 1 mo to 14 y old, admitted to the PICU with severe sepsis or septic shock from January 2007 through December 2008 was done. Demographic, clinical and laboratory features of subjects were reviewed. The primary outcome was mortality at the time of discharge from PICU. The independent predictors of mortality were modeled using multiple logistic regression. Results In 2 years, 17.3% (133/767) children admitted to the PICU had sepsis. Median age was 18 mo (IQR 6-93 mo), with male: female ratio of 1.6:1. Mean PRISM III score was 9 (±7.8). One third had culture proven infection, majority (20%) having bloodstream infection. The frequency of multi-organ dysfunction syndrome (MODS) was 81% (108/133). The case specific mortality rate of sepsis was 24% (32/133). Multi-organ dysfunction (Adjusted OR 18.0, 95% CI 2.2-144), prism score of >10 (Adjusted OR 1.5, 95% CI 0.6-4.0) and the need for>2 inotropes (Adjusted OR 3.5, 95% CI 1.3-9.2) were independently associated with mortality due to sepsis. Conclusions The presence of septic shock and MODS is associated with high mortality in the PICU of developing countries.
AB - Objective To determine the epidemiology and outcome of sepsis in children admitted in pediatric intensive care unit (PICU) of a tertiary care hospital. Methods Retrospective review of children 1 mo to 14 y old, admitted to the PICU with severe sepsis or septic shock from January 2007 through December 2008 was done. Demographic, clinical and laboratory features of subjects were reviewed. The primary outcome was mortality at the time of discharge from PICU. The independent predictors of mortality were modeled using multiple logistic regression. Results In 2 years, 17.3% (133/767) children admitted to the PICU had sepsis. Median age was 18 mo (IQR 6-93 mo), with male: female ratio of 1.6:1. Mean PRISM III score was 9 (±7.8). One third had culture proven infection, majority (20%) having bloodstream infection. The frequency of multi-organ dysfunction syndrome (MODS) was 81% (108/133). The case specific mortality rate of sepsis was 24% (32/133). Multi-organ dysfunction (Adjusted OR 18.0, 95% CI 2.2-144), prism score of >10 (Adjusted OR 1.5, 95% CI 0.6-4.0) and the need for>2 inotropes (Adjusted OR 3.5, 95% CI 1.3-9.2) were independently associated with mortality due to sepsis. Conclusions The presence of septic shock and MODS is associated with high mortality in the PICU of developing countries.
KW - Pakistan
KW - Pediatric intensive care
KW - Sepsis
KW - Septic shock
KW - Tertiary care
UR - http://www.scopus.com/inward/record.url?scp=84871320837&partnerID=8YFLogxK
U2 - 10.1007/s12098-012-0706-z
DO - 10.1007/s12098-012-0706-z
M3 - Article
C2 - 22392263
AN - SCOPUS:84871320837
SN - 0019-5456
VL - 79
SP - 1454
EP - 1458
JO - Indian Journal of Pediatrics
JF - Indian Journal of Pediatrics
IS - 11
ER -