Different methods in predicting mortality of pediatric intensive care units sepsis in Southwest China
10.3760/cma.j.cn112140-20231013-00282
- VernacularTitle:不同方法对中国西南地区儿童重症监护病房脓毒症病死率的预测价值
- Author:
Rong LIU
1
;
Zhicai YU
;
Changxue XIAO
;
Shufang XIAO
;
Juan HE
;
Yan SHI
;
Yuanyuan HUA
;
Jimin ZHOU
;
Guoying ZHANG
;
Tao WANG
;
Jianyu JIANG
;
Daoxue XIONG
;
Yan CHEN
;
Hongbo XU
;
Hong YUN
;
Hui SUN
;
Tingting PAN
;
Rui WANG
;
Shuangmei ZHU
;
Dong HUANG
;
Yujiang LIU
;
Yuhang HU
;
Xinrui REN
;
Mingfang SHI
;
Sizun SONG
;
Jumei LUO
;
Juan LIU
;
Juan ZHANG
;
Feng XU
Author Information
1. 重庆医科大学附属儿童医院重症医学科 国家儿童健康与疾病临床医学研究中心 儿童发育疾病研究教育部重点实验室 儿童代谢与炎症性疾病重庆市重点实验室，重庆 400014
- Keywords:
Sepsis;
Intensive care units, pediatric;
Forecasting
- From:
Chinese Journal of Pediatrics
2024;62(3):204-210
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of systemic inflammatory response syndrome (SIRS), pediatric sequential organ failure assessment (pSOFA) and pediatric critical illness score (PCIS) in predicting mortality of pediatric sepsis in pediatric intensive care units (PICU) from Southwest China.Methods:This was a prospective multicenter observational study. A total of 447 children with sepsis admitted to 12 PICU in Southwest China from April 2022 to March 2023 were enrolled. Based on the prognosis, the patients were divided into survival group and non-survival group. The physiological parameters of SIRS, pSOFA and PCIS were recorded and scored within 24 h after PICU admission. The general clinical data and some laboratory results were recorded. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare the predictive value of SIRS, pSOFA and PCIS in mortality of pediatric sepsis.Results:Amongst 447 children with sepsis, 260 patients were male and 187 patients were female, aged 2.5 (0.8, 7.0) years, 405 patients were in the survival group and 42 patients were in the non-survival group. 418 patients (93.5%) met the criteria of SIRS, and 440 patients (98.4%) met the criteria of pSOFA≥2. There was no significant difference in the number of items meeting the SIRS criteria between the survival group and the non-survival group (3(2, 4) vs. 3(3, 4) points, Z=1.30, P=0.192). The pSOFA score of the non-survival group was significantly higher than that of the survival group (9(6, 12) vs. 4(3, 7) points, Z=6.56, P<0.001), and the PCIS score was significantly lower than that of the survival group (72(68, 81) vs. 82(76, 88) points, Z=5.90, P<0.001). The predictive value of pSOFA (AUC=0.82) and PCIS (AUC=0.78) for sepsis mortality was significantly higher than that of SIRS (AUC=0.56) ( Z=6.59, 4.23, both P<0.001). There was no significant difference between pSOFA and PCIS ( Z=1.35, P=0.176). Platelet count, procalcitonin, lactic acid, albumin, creatinine, total bilirubin, activated partial thromboplastin time, prothrombin time and international normalized ratio were all able to predict mortality of sepsis to a certain degree (AUC=0.64, 0.68, 0.80, 0.64, 0.68, 0.60, 0.77, 0.75, 0.76, all P<0.05). Conclusion:Compared with SIRS, both pSOFA and PCIS had better predictive value in the mortality of pediatric sepsis in PICU.
