Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to Sepsis

Objective: Sepsis is a serious disease in children and necessitates accurate mortality risk assessment. This study aims to evaluate the effectiveness of clinical findings, laboratory parameters, and scoring systems in predicting mortality and morbidity in pediatric sepsis cases in the pediatric inte...

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Main Authors: Esra Usluer, Ayşe Berna Anıl, Murat Anıl, Fulya Kamit, Ümüt Altuğ, Gökçen Özçifçi, Neslihan Zengin, Fatih Durak
Format: Article
Language:English
Published: Galenos Publishing House 2025-08-01
Series:Journal of Behçet Uz Children's Hospital
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Online Access:https://behcetuzdergisi.com/articles/clinical-outcomes-and-mortality-predictors-in-patients-hospitalized-in-the-pediatric-intensive-care-unit-due-to-sepsis/doi/jbuch.galenos.2025.03453
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Summary:Objective: Sepsis is a serious disease in children and necessitates accurate mortality risk assessment. This study aims to evaluate the effectiveness of clinical findings, laboratory parameters, and scoring systems in predicting mortality and morbidity in pediatric sepsis cases in the pediatric intensive care unit (PICU). Method: Clinical and laboratory parameters, Pediatric Index of Mortality (PIM) II, Pediatric Risk of Mortality III, Pediatric Logistic Organ Dysfunction (PELOD) and Vasoactive Inotropic Scoring (VIS) scores of 219 patients, aged between 1 month and 18 years, diagnosed with sepsis and septic shock between 2010 and 2016 were retrospectively evaluated. Results: The mortality rate of the patients was 32.9% (72/219). The specified percentages of patients had an underlying disease (73.1%), required invasive mechanical ventilation (IMV) support (80%), and had a median hospitalization time of 11 days, while 77.2% of the patients were diagnosed with septic shock. In the multivariate logistic regression analysis, higher PIM II [odds ratio (OR): 1.027, p=0.010], PELOD OR: 1.024, p=0.001), Vasoactive-Inotropic Score (VIS) (OR: 1.016, p<0.001) scores, and lactate levels (OR: 1.143, p=0.032) were identified as significant predictors of mortality in pediatric sepsis patients. In receiver operating characteristic analysis, VIS had the highest predictive power [area under the curve: 0.820]. The partial pressure of carbon dioxide (PCO2) significantly correlated with the length of stay in PICU (r=0.407). PIM II remarkably correlated with the duration of IMV support (r=0.516). Conclusion: The most efficient parameters to assess mortality in pediatric sepsis were VIS, PIM II and PELOD, respectively. PCO2 correlated with the length of stay in the PICU, and PIM II with the duration of IMV support.
ISSN:2822-4469