Clinical Profile, Immediate Outcome and Predictors of Poor Outcome of Children in Pediatric Intensive Care Unit with Sepsis

Abstract

Introduction 
Sepsis remains a major cause of death  in children with death rate ranging from 5% in developed countries to 35% in developing countries. However, data on the predictive factors for poor outcome particularly in developing countries, remain limited. So this study aims to evaluate the clinical profile, immediate outcome and factors associated with poor outcome of the children with sepsis.

Methods
This retrospective study was conducted in the Pediatric Intensive Care Unit (PICU) at Kanti Children Hospital, Kathmandu. Medical records of  patients  aged   30 days  to 14 years, diagnosed with sepsis based on clinical and laboratory parameters and admitted  to the PICU between April 2024 to September 2024  were analyzed. The clinical features, outcome in the form of discharge or death during the hospital stay and factors effecting the poor outcome were tabulated and the data analysis was done by SPSS version 21.

Results
The total number of patient enrolled in the study were 53. The mean age of the patient was (3.49±0.183) yrs. Among them 31/53(58 %) were male and 22/53(42%) were female. Among them 42/53(79.25%) were Hindus 5/53(9.43%) were Muslims 4/53(7.54%) Buddhist and 2/53 (3.77%) Christian. The most common presenting symptom was fever observed in 50/53(94.4%) of cases. The mortality rate for sepsis was (14/53)26.41% which is  statistically significant. Predictors of poor outcome included were the need for dialysis (p=0.016), the presence of Central Nervous System disease (p=0.001), the use of mechanical ventilation (p=0.00), the use of ionotropic support (p=0.010) and elevated D-dimer levels (p=0.036).

Conclusion
Fever was the most common symptom of sepsis with a mortality rate of 26.41%. Key predictors of poor outcome included the need of  dialysis, presence of CNS disease, mechanical ventilation, the use of ionotropic support and elevated D-dimer level.