Factors associated with mortality in severely malnourished hospitalized children who developed septic shock
Introduction: Septic shock can often lead to death, even in resourceful settings, if not handled carefully. Therefore, we sought to evaluate the factors associated with deaths in the context of severe malnutrition and also the effects of early, i.e., within 3 hours of diagnosing septic shock vs. la...
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The Journal of Infection in Developing Countries
2022-02-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/15135 |
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| author | Visnu Pritom Chowdhury Monira Sarmin Mehnaz Kamal Shafiul Islam Mohammad Abubakar Siddik Farzana Afroze Muhammad Waliur Rahman Tahmeed Ahmed Mohammod Jobayer Chisti |
| author_facet | Visnu Pritom Chowdhury Monira Sarmin Mehnaz Kamal Shafiul Islam Mohammad Abubakar Siddik Farzana Afroze Muhammad Waliur Rahman Tahmeed Ahmed Mohammod Jobayer Chisti |
| author_sort | Visnu Pritom Chowdhury |
| collection | DOAJ |
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Introduction: Septic shock can often lead to death, even in resourceful settings, if not handled carefully. Therefore, we sought to evaluate the factors associated with deaths in the context of severe malnutrition and also the effects of early, i.e., within 3 hours of diagnosing septic shock vs. late blood transfusion.
Methodology: Here, all under-five severely malnourished septic shock children were admitted to ICU during 2013-2017. Children who died constituted cases (n = 54), and the survived (n = 39) represented controls. We excluded children who received the blood transfusion for other causes and who left against medical advice.
Results: In both descriptive and multivariate analysis, we found that death was significantly associated with the use of fourth-line antibiotics, corticosteroids, and the addition of vasopressors on top of dopamine (all p < 0.05). However, the decrease of serum calcium level was found significantly associated with death only after adjusting (p < 0.05). Even though the cases more often received early blood transfusion than the controls, the difference was insignificant (p = 0.134).
Conclusions: When a severely malnourished under-five child develops septic shock, requiring vasopressors, fourth-line antibiotic, and corticosteroid, with reduced serum calcium, the probability of death increases significantly. Our findings underscore the gravity of close monitoring at these points and the niches for early interventions.
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| format | Article |
| id | doaj-art-44e86e3edbc541c3a2a513ba6982ee83 |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2022-02-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-44e86e3edbc541c3a2a513ba6982ee832025-08-20T02:16:17ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802022-02-01160210.3855/jidc.15135Factors associated with mortality in severely malnourished hospitalized children who developed septic shockVisnu Pritom Chowdhury0Monira Sarmin1Mehnaz Kamal2Shafiul Islam3Mohammad Abubakar Siddik4Farzana Afroze5Muhammad Waliur Rahman6Tahmeed Ahmed7Mohammod Jobayer Chisti8Nutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, BangladeshNutrition and Clinical Services Division (NCSD), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh Introduction: Septic shock can often lead to death, even in resourceful settings, if not handled carefully. Therefore, we sought to evaluate the factors associated with deaths in the context of severe malnutrition and also the effects of early, i.e., within 3 hours of diagnosing septic shock vs. late blood transfusion. Methodology: Here, all under-five severely malnourished septic shock children were admitted to ICU during 2013-2017. Children who died constituted cases (n = 54), and the survived (n = 39) represented controls. We excluded children who received the blood transfusion for other causes and who left against medical advice. Results: In both descriptive and multivariate analysis, we found that death was significantly associated with the use of fourth-line antibiotics, corticosteroids, and the addition of vasopressors on top of dopamine (all p < 0.05). However, the decrease of serum calcium level was found significantly associated with death only after adjusting (p < 0.05). Even though the cases more often received early blood transfusion than the controls, the difference was insignificant (p = 0.134). Conclusions: When a severely malnourished under-five child develops septic shock, requiring vasopressors, fourth-line antibiotic, and corticosteroid, with reduced serum calcium, the probability of death increases significantly. Our findings underscore the gravity of close monitoring at these points and the niches for early interventions. https://jidc.org/index.php/journal/article/view/15135Septic shocksevere acute malnutritionsepsismalnutritionblood transfusion |
| spellingShingle | Visnu Pritom Chowdhury Monira Sarmin Mehnaz Kamal Shafiul Islam Mohammad Abubakar Siddik Farzana Afroze Muhammad Waliur Rahman Tahmeed Ahmed Mohammod Jobayer Chisti Factors associated with mortality in severely malnourished hospitalized children who developed septic shock Journal of Infection in Developing Countries Septic shock severe acute malnutrition sepsis malnutrition blood transfusion |
| title | Factors associated with mortality in severely malnourished hospitalized children who developed septic shock |
| title_full | Factors associated with mortality in severely malnourished hospitalized children who developed septic shock |
| title_fullStr | Factors associated with mortality in severely malnourished hospitalized children who developed septic shock |
| title_full_unstemmed | Factors associated with mortality in severely malnourished hospitalized children who developed septic shock |
| title_short | Factors associated with mortality in severely malnourished hospitalized children who developed septic shock |
| title_sort | factors associated with mortality in severely malnourished hospitalized children who developed septic shock |
| topic | Septic shock severe acute malnutrition sepsis malnutrition blood transfusion |
| url | https://jidc.org/index.php/journal/article/view/15135 |
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