Prognostic Factors in Pediatric Sepsis Study, From the Spanish Society of Pediatric Intensive Care

Pérez, David Vila; Jordán, Iolanda; Esteban, Elisabeth; García-Soler, Patricia; Murga, Vega; Bonil, Vanesa; Ortiz, Irene; Flores, Carlos; Bustinza, Amaya; Cambra, Francisco José

doi:10.1097/01.inf.0000435502.36996.72

Cited by 35 publications

(29 citation statements)

References 51 publications

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“…The sample analyzed included 63.5% male patients, a number quite similar to the 2011 study ( 7 ) and similar to other previous studies. ( 14 - 18 ) The age analysis of this study’s patients showed they were mostly younger than 12 months (54.8%) and younger than 36 months in 73% of cases, which is similar to most studies.…”

Section: Discussionsupporting

confidence: 73%

“…The presence of comorbidities among the study’s children was small (24.3%) compared to the literature, which reports percentages ranging from 40 to 91%. ( 7 , 11 , 14 - 17 , 19 ) This finding reflects the characteristics of the setting in which the study was conducted, which was a pediatric ICU with a general profile of admissions for community-acquired clinical diseases.…”

Section: Discussionmentioning

confidence: 75%

“…The prevalence observed is similar to the literature, which reports values from 2.1 to 11.8%. ( 7 , 8 , 11 , 15 , 16 , 19 )…”

Section: Discussionmentioning

confidence: 99%

“…The mortality rate (13%) observed in this study was within the values found in the literature (8.8% to 56.1%) and was 23.8% in the age group from 12 to 36 months. ( 7 , 14 - 17 ) A Brazilian study reviewing data from the Hospital Information System of the Unified Health System (Sistema de Informações Hospitalares do Sistema Único de Saúde, SIH-SUS) found a mortality rate from sepsis, in the period from 1992 to 2006, ranging from 19.7 to 20.5%, which was highest in the age group from 1 month to 1 year. ( 18 ) A Japanese study observed an 18.9% overall mortality from sepsis, including 25% in adolescents, 26% in children and 14% in infants, ( 19 ) in contrast to other studies that show a higher mortality rate among infants.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to treatment, other factors are associated with unfavorable progression of sepsis among intensive care patients, including the diagnosis time and host reaction responses to the infection. ( 7 , 13 )…”

Section: Introductionmentioning

confidence: 99%

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Etiology and prognostic factors of sepsis among children and adolescents admitted to the intensive care unit

Pedro¹,

Morcillo²,

Baracat³

2015

Revista Brasileira De Terapia Intensiva

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ObjectiveTo determine the etiology and clinical disease progression variables of sepsis associated with the prognosis of patients admitted to a pediatric intensive care unit.MethodsProspective and retrospective case series. Data were collected from the medical records of patients diagnosed with sepsis who were admitted to the pediatric intensive care unit of a general hospital from January 2011 to December 2013. Bacteria were identified in blood and fluid cultures. Age, sex, vaccination schedule, comorbidities, prior antibiotic use, clinical data on admission, and complications during disease progression were compared in the survival and death groups at a 5% significance level.ResultsA total of 115 patients, with a mean age of 30.5 months, were included in the study. Bacterial etiology was identified in 40 patients. Altered peripheral perfusion on admission and diagnosis of severe sepsis were associated with complications. A greater number of complications occurred in the group of patients older than 36 months (p = 0.003; odds ratio = 4.94). The presence of complications during hospitalization was associated with death (odds ratio = 27.7). The main etiological agents were Gram-negative bacteria (15/40), Staphylococcus aureus (11/40) and Neisseria meningitidis (5/40).ConclusionGram-negative bacteria and Staphylococcus aureus predominated in the etiology of sepsis among children and adolescents admitted to an intensive care unit. The severity of sepsis and the presence of altered peripheral perfusion on admission were associated with complications. Moreover, the presence of complications was a factor associated with death.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 75%

“…The prevalence observed is similar to the literature, which reports values from 2.1 to 11.8%. ( 7 , 8 , 11 , 15 , 16 , 19 )…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Etiology and prognostic factors of sepsis among children and adolescents admitted to the intensive care unit

Pedro¹,

Morcillo²,

Baracat³

2015

Revista Brasileira De Terapia Intensiva

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Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock

et al. 2019

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IMPORTANCE The global patterns and distribution of case-fatality rates (CFRs) in pediatric severe sepsis and septic shock remain poorly described. OBJECTIVE We performed a systematic review and meta-analysis of studies of children with severe sepsis and septic shock to elucidate the patterns of CFRs in developing and developed countries over time. We also described factors associated with CFRs. DATA SOURCES We searched PubMed, Web of Science, Excerpta Medica database, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane Central systematically for randomized clinical trials and prospective observational studies from earliest publication until January 2017, using the keywords "pediatric," "sepsis," "septic shock," and "mortality." STUDY SELECTION Studies involving children with severe sepsis and septic shock that reported CFRs were included. Retrospective studies and studies including only neonates were excluded. DATA EXTRACTION AND SYNTHESIS We conducted our systematic review and meta-analysis in close accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled case-fatality estimates were obtained using random-effects meta-analysis. The associations of study period, study design, sepsis severity, age, and continents in which studies occurred were assessed with meta-regression. MAIN OUTCOMES AND MEASURES Meta-analyses to provide pooled estimates of CFR of pediatric severe sepsis and septic shock over time. RESULTS Ninety-four studies that included 7561 patients were included. Pooled CFRs were higher in developing countries (31.7% [95% CI, 27.3%-36.4%]) than in developed countries (19.3% [95% CI, 16.4%-22.7%]; P < .001). Meta-analysis of CFRs also showed significant heterogeneity across studies. Continents that include mainly developing countries reported higher CFRs (adjusted odds ratios: Africa, 7.89 [95% CI, 6.02-10.32]; P < .001; Asia, 3.81 [95% CI, 3.60-4.03]; P < .001; South America, 2.91 [95% CI, 2.71-3.12]; P < .001) than North America. Septic shock was associated with higher CFRs than severe sepsis (adjusted odds ratios, 1.47 [95% CI, 1.41-1.54]). Younger age was also a risk factor (adjusted odds ratio, 0.95 [95% CI, 0.94-0.96] per year of increase in age). Earlier study eras were associated with higher CFRs (adjusted odds ratios for 1991-2000, 1.24 [95% CI, 1.13-1.37]; P < .001) compared with 2011 to 2016. Time-trend analysis showed higher CFRs over time in developing countries than developed countries. CONCLUSIONS AND RELEVANCE Despite the declining trend of pediatric severe sepsis and septic shock CFRs, the disparity between developing and developed countries persists. Further characterizations of vulnerable populations and collaborations between developed and developing countries are warranted to reduce the burden of pediatric sepsis globally.

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Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis

et al. 2020

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Purpose: Sepsis is recognized as a global public health problem, but the proportion due to hospital-acquired infections remains unclear. We aimed to summarize the epidemiological evidence related to the burden of hospitalacquired (HA) and ICU-acquired (ICU-A) sepsis. Methods: We searched MEDLINE, Embase and the Global Index Medicus from 01/2000 to 03/2018. We included studies conducted hospital-wide or in intensive care units (ICUs), including neonatal units (NICUs), with data on the incidence/prevalence of HA and ICU-A sepsis and the proportion of community and hospital/ICU origin. We did random-effects meta-analyses to obtain pooled estimates; inter-study heterogeneity and risk of bias were assessed. Results: Of the 13,239 studies identified, 51 met the inclusion criteria; 22 were from low-and middle-income countries. Twenty-eight studies were conducted in ICUs, 13 in NICUs, and ten hospital-wide. The proportion of HA sepsis among all hospital-treated sepsis cases was 23.6% (95% CI 17-31.8%, range 16-36.4%). In the ICU, 24.4% (95% CI 16.7-34.2%, range 10.3-42.5%) of cases of sepsis with organ dysfunction were acquired during ICU stay and 48.7% (95% CI 38.3-59.3%, range 18.7-69.4%) had a hospital origin. The pooled hospital incidence of HA sepsis with organ dysfunction per 1000 patients was 9.3 (95% CI 7.3-11.9, range 2-20.6)). In the ICU, the pooled incidence of HA sepsis with organ dysfunction per 1000 patients was 56.5 (95% CI 35-90.2, range 9.2-254.4) and it was particularly high in NICUs. Mortality of ICU patients with HA sepsis with organ dysfunction was 52.3% (95% CI 43.4-61.1%, range 30.1-64.6%). There was a significant inter-study heterogeneity. Risk of bias was low to moderate in ICU-based studies and moderate to high in hospital-wide and NICU studies.

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Prognostic Factors in Pediatric Sepsis Study, From the Spanish Society of Pediatric Intensive Care

Abstract: Patients with sepsis and multiorgan failure, especially those with nosocomial infection or the presence of neutropenia or purpura, have a worse prognosis and should be monitored and treated early.

Cited by 35 publications

References 51 publications

Etiology and prognostic factors of sepsis among children and adolescents admitted to the intensive care unit

Etiology and prognostic factors of sepsis among children and adolescents admitted to the intensive care unit

Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock

Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis

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