Early predictor of mortality in septic shock in paediatric critical care unit

Background: Sepsis is a common problem in paediatric critical care units. It has different clinical spectra like systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock and multi-organ failure. As per previously reported studies, sepsis accounts for 80% of under-five mortality worldwide. Septic shock is a fatal complication of sepsis. Thus, early identification and treatment is key in management of sepsis.
Objectives: To identify early predictors of poor outcome of septic shock patients in the paediatric intensive care unit (PICU)
Method: This was a retrospective observational study in the critical care ICU of a tertiary care hospital in Western India. Patients fulfilling inclusion criteria were included in study. Demographic factors and clinical factors were noted.  Relevant investigations were sent and patients were managed as per hospital protocols.
Results: There was a total of 51 cases of septic shock with different aetiology admitted in our hospital. There were 29 (56.9%) males and 22 (43.1%) females. Mean age of study participants was 3.25+3.77 years. Most of them had septic shock due to respiratory diseases (pneumonia 29.4%). Out of 51 cases 34 (66.7%) died and 17 (33.3%) survived. There was no significant difference between age distribution and gender distribution among deaths and survivals (p>0.05). Incomplete immunization, altered sensorium and decreased urine output had a significant effect on outcome (death) of study participants (p<0.05). Among laboratory findings, decreased platelet count, hyperkalaemia and oxygen saturation on room air had a significant role in disease outcome (p<0.05).
Conclusions: Incomplete immunization, oxygen saturation on room air, altered sensorium, decreased urine output, decreased platelet count and hyperkalaemia had significant effects on disease outcome.