Epidemiological characteristics of septic shock in children and risk factors for prognosis / 中国小儿急救医学

ABSTRACT

Objective:To explore the epidemiological characteristics of septic shock in children and analyse the risk factors for prognosis.Methods:Retrospective study was conducted to collect the clinical data of 90 children with septic shock admitted to PICU from January 2017 to July 2020.Logistic regression analysis was used to analyze the epidemiological characteristics and risk factors of death of children with septic shock.Results:Among the 90 children with septic shock, 27 patients died, with a fatality rate of 30.0%.The primary infection sites were mainly in lungs and gastrointestinal/abdominal cavity, and the mortality rate of children with septic shock caused by primary gastrointestinal/abdominal infection was higher than that of lungs infection(48.1% vs.23.7%, χ2=6.049, P<0.05), and the time of death was shorter than that of lungs infection[2.1(0.9, 6.5)d vs.8.0(2.2, 13.5)d, H=2.052, P<0.05]. With the prognosis of children as dependent variable, the sex, age, pediatric critical illness score, glasgow coma scale, hypotension, combination with basic diseases, high lactic acidosis as well as severe pneumonia, gastrointestinal function failure, liver failure, acute kidney injury, and stress hyperglycemia were introduced to Logistic regression equation.The results showed that pediatric critical illness score, hypotension, combination with basic diseases, gastrointestinal function failure, liver failure, and acute kidney injury were related to the prognosis of children with septic shock, and hypotension, gastrointestinal function failure and combination with basic diseases were independent risk factors for death in children with septic shock. Conclusion:It is necessary to strengthen early intervention for primary gastrointestinal/abdominal infection, combined with underlying diseases and septic shock in compensatory stage.