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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author Esra Usluer
Ayşe Berna Anıl
Murat Anıl
Fulya Kamit
Ümüt Altuğ
Gökçen Özçifçi
Neslihan Zengin
Fatih Durak
author_facet Esra Usluer
Ayşe Berna Anıl
Murat Anıl
Fulya Kamit
Ümüt Altuğ
Gökçen Özçifçi
Neslihan Zengin
Fatih Durak
author_sort Esra Usluer
collection DOAJ
description 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.
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spelling doaj-art-0fdcaf96982e4a94a7f0d4d4a1d01e9c2025-08-20T03:59:36ZengGalenos Publishing HouseJournal of Behçet Uz Children's Hospital2822-44692025-08-0115211112010.4274/jbuch.galenos.2025.03453Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to SepsisEsra Usluer0https://orcid.org/0000-0003-4849-2078Ayşe Berna Anıl1https://orcid.org/0000-0003-3670-3771Murat Anıl2https://orcid.org/0000-0002-2596-4944Fulya Kamit3https://orcid.org/0000-0003-1078-9781Ümüt Altuğ4https://orcid.org/0000-0002-6864-377XGökçen Özçifçi5https://orcid.org/0000-0001-5245-9786Neslihan Zengin6https://orcid.org/0000-0002-3575-7033Fatih Durak7https://orcid.org/0000-0002-3209-2697University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatrics, İzmir, Turkeyİzmir Katip Çelebi University Faculty of Medicine, Department of Pediatric Intensive Care Unit, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Emergency, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Intensive Care Unit, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Intensive Care Unit, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Intensive Care Unit, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Intensive Care Unit, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Intensive Care Unit, İzmir, TurkeyObjective: 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.https://behcetuzdergisi.com/articles/clinical-outcomes-and-mortality-predictors-in-patients-hospitalized-in-the-pediatric-intensive-care-unit-due-to-sepsis/doi/jbuch.galenos.2025.03453sepsismortalityvispim iipicu
spellingShingle Esra Usluer
Ayşe Berna Anıl
Murat Anıl
Fulya Kamit
Ümüt Altuğ
Gökçen Özçifçi
Neslihan Zengin
Fatih Durak
Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to Sepsis
Journal of Behçet Uz Children's Hospital
sepsis
mortality
vis
pim ii
picu
title Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to Sepsis
title_full Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to Sepsis
title_fullStr Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to Sepsis
title_full_unstemmed Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to Sepsis
title_short Clinical Outcomes and Mortality Predictors in Patients Hospitalized in the Pediatric Intensive Care Unit due to Sepsis
title_sort clinical outcomes and mortality predictors in patients hospitalized in the pediatric intensive care unit due to sepsis
topic sepsis
mortality
vis
pim ii
picu
url 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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