Title: Clinical, Demographic Profile and Outcome of Children Admitted in PICU with A Diagnosis of Severe Sepsis and Septic Shock

Authors: Ghimire Jagat Jeevan, Gami Fakir Chandra, Thapa Surya Bahadur

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.40

Abstract

Background: To determine profile and outcome of children with severe sepsis and/or septic shock.

Material and Methodology: The prospective observational study was done in 47 children with severe sepsis and septic shock admitted in PICU. Demographic data, clinical finding, lactate at admission and lactate clearance and PRISMIII score were recorded. The patients were followed daily, maximum up to 5 days or till death or discharge from PICU. PRISM III was correlated with in-hospital mortality and morbidity.

Results: Out of 234 patients admitted 57(24%) had the diagnosis of sepsis.47 patients were included in the study. Male female ratio was 1.76:1.Mean age of patients was 88.79 months. Mean duration of illness was 7.13 days. Pneumonia was the most common diagnosis. Mean length of PICU stay was 160 hours and mortality was 25%.Nonsurvivors didn’t differ from survivors in terms of age, duration of illness, platelet count, lactate at admission and lactate clearance. Survivors differed from non-survivors in terms of PRISM III score (19.77 vs 36.33) with p-value of .003. PRISMIII had excellent accuracy of death prediction of death with AUC of 0 .852(95% CI 0.702-0.900)

Conclusion: Sepsis remain as leading cause of mortality in PICU.PRISMIII had the excellent prediction of death.

Keywords:  PRISMIII, Severe Sepsis, Septic shock, PICU.

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