Clinical characteristics and risk factors associated with prognosis of sepsis in children

Abstract:

Objective：To analyze the clinical characteristics and prognosis of sepsis in children and to provide references for early di－agnosis and treatment. Methods：A retrospective study was performed on 105 patients with sepsis hospitalized in Children’s Hospital of Chongqing Medical University from January 2007 to October 2012. Results：There were 74 males（70.5%） and 31 females（29.5%），and most of them were under 3 years old（65.7%）. The clinical manifestations varied. Sepsis could result in multiple sites of infection and organ dysfunction syndrome（MODS）（64.8%）. The most common sites of infection were lung（92.4%），skin and soft tissue（35.2%），and intracalvarium（32.4%）. The main dysfunctional organs were respiratory system（54.3%），hematologic system（50.5%） and liver（44.8%）. The most common initial site of infection were lung（41.9%），skin and soft tissue（21.0%），and digestive system（17.1%）. In the univariate analysis，variables significantly associated with prognosis were increased dysfunctional organs（Z=-5.940，P=0.000），septic shock（χ2=8.531，P=0.003），white blood count（Z=-2.100，P=0.036），platelet count（Z=-2.925，P=0.003），serum procalcitonin（Z=-2.125，P=0.034），serum D-dimer（Z=-3.748，P=0.000），electrolyte disturbance（χ2=5.899，P=0.015），anti-infective therapy at one hour after admitting to hospital（χ2=4.594，P=0.032）. And the logistic regression model showed increased dysfunctional organs and anti-infective therapy at one hour after admitting to hospital were risk factors associated with prognosis. Conclusion：Most patients with sepsis in children are less than 3 years old. The clinical manifestations of sepsis vary and sepsis could result in MODS. The most com－mon dysfunctional organ and infection site is respiratory system and the most common initial infection site was lung. Increased dys－functional organs and anti-infective therapy at one hour after admitting to hospital are the risk factors for death.