Characterization and prognostic factors of children with sepsis in a high complexity hospital

Abstract

Objective: To describe the clinical and laboratory characteristics of patients with sepsis admitted to a high-complexity healthcare center in Latin America. 

Patients and Method: Descriptive observational study. Patients between one month to 17 years of age with sepsis diagnosis were included. Studied variables included demographics, clinical and laboratory characteristics, and treatment administered, determining predictors of mortality. A descriptive analysis was performed using the Chi-square or Fisher test. 

Results: 186 patients were included and 72% of them had comorbidities. Respiratory disease was the most frequent source of sepsis (29%), followed by gastrointestinal infection (11%) and catheter-related bacteremia (11%). 60% of patients had at least one organ dysfunction, the most frequent being respiratory dysfunction (70%). 60% of the patients presented multiple organ dysfunction syndrome (MODS). Blood cultures showed a positive result in 37% of cases. The two most common first-hour interventions included IV resuscitation fluids (67%) and antibiotics (36%). Vasopressor support and mechanical ventilation were used in 33% and 34% of patients, respectively. Overall mortality was 12% and was higher in patients diagnosed with MODS (59%) or who presented with some organ dysfunction. 

Conclusion: Organ dysfunction was frequent. Patients with some type of organ dysfunction or MODS presented higher mortality. Despite global and institutional guidelines focused on improving diagnosis and treatment, in less than half of the patients sepsis was adequately detected and first-hour IV fluids and antibiotics administration rates were below 70%.