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Table 2 Predictors of death in children with community-acquired sepsis

From: Mortality and morbidity in community-acquired sepsis in European pediatric intensive care units: a prospective cohort study from the European Childhood Life-threatening Infectious Disease Study (EUCLIDS)

 

Sepsis survivors (n = 744)

Deaths (n = 51)

Univariable odds ratio for death (95% CI)

P

Multivariable odds ratio for death (95% CI)

P

Sex

 Male

399/744 (54%)

29/51 (57%)

Reference

   

 Female

345/744 (46%)

22/51 (43%)

0.9 (0.5–1.6)

0.65

NA

Age

 29 days–12 months (infants)

248/744 (33%)

13/51 (26%)

Reference

   

 1–5 years (toddlers)

259/744 (35%)

19/51 (37%)

1.4 (0.7–2.9)

0.37

NA

 5–12 years (school -aged children)

140/744 (19%)

11/51 (22%)

1.5 (0.7–3.4)

0.34

NA

 12–18 years (adolescents)

97/744 (13%)

8/51 (16%)

1.6 (0.6–3.9)

0.33

NA

Time interval from onset of symptoms to hospital admissiona (days)

1 (1–3)

2 (1–4)

1.0 (1.0–1.1)

0.47

NA

 

Immunizations up to date

 No

70/621 (11%)

2/36 (6%)

Reference

   

 Yes

551/621 (89%)

34/36 (94%)

2.2 (0.5–9.2)

0.30

NA

Underlying condition

 No

479/744 (64%)

28/51 (55%)

Reference

   

 Yes

265/744 (36%)

23/51 (45%)

1.5 (0.8–2.6)

0.18

0.7 (0.2–2.0)

0.46

Illness severity

 PRISM scoreb

14 (7–20)

22 (15–30)

1.1 (1.0–1.1)

< 0.001

NA

 

 PIM2 scorec (predicted death, %)

3.9 (1.0–9.1)

14.7 (3.8–48.0)

3.9 (2.1–7.2)

< 0.001

2.8 (1.3–6.1)

< 0.01

 Lactate at PICU admissiond (mmol/L)

1.7 (1.0–3.3)

3.3 (2.3–5.4)

8.9 (2.7–29.1)

< 0.001

NA

 

 Invasive ventilation

474/705 (67%)

45/47 (96%)

11.0 (2.6–45.6)

0.001

NA

 Inotropes

377/693 (54%)

41/46 (89%)

6.9 (2.7–17.6)

< 0.001

NA

Bacteremia

 No

445/741 (60%)

13/51 (26%)

Reference

   

 Yes

296/741 (40%)

38/51 (75%)

4.4 (2.3–8.4)

< 0.001

7.4 (1.0–56.6)

0.06

Clinical syndromes

 No focus

254/744 (34%)

24/51 (47%)

1.7 (1.0–3.0)

0.06

3.0 (0.8–10.9)

0.09

 Meningitis/encephalitis

172/744 (23%)

10/51 (20%)

0.8 (0.4–1.6)

0.56

NA

 

 Pneumonia

138/744 (19%)

11/51 (22%)

1.2 (0.6–2.4)

0.59

NA

 Other focus

180/744 (24%)

6/51 (12%)

0.4 (0.2–1.0)

0.05

1.8 (0.3–11.8)

0.52

Invasive pathogense

 N. meningitidis

120/386 (31%)

11/39 (28%)

0.8 (0.4–1.8)

0.88

NA

 

 S. pneumoniae

65/386 (17%)

13/39 (33%)

2.5 (1.2–5.1)

0.01

4.1 (1.1–16.0)

0.04

 Group A streptococcus

60/386 (16%)

6/39 (15%)

1.0 (0.4–2.5)

1.0

NA

 

 S. aureus

37/386 (10%)

4/39 (10%)

1.1 (0.4–3.2)

0.88

NA

 

 Other invasive pathogen

104/386 (27%)

5/39 (13%)

0.4 (0.2–1.0)

0.06

0.3 (0.0–2.2)

0.21

  1. This study included 795 children admitted with community-acquired sepsis, of whom 51 patients died. Multivariable analysis included variables with a P value < 0.20 in univariable analysis. Because parameters of illness severity are strongly correlated, only the Pediatric Index of Mortality 2 (PIM2) [28] score has been included in multivariable analysis. Values are reported as counts (percentages) or medians (interquartile ranges), unless stated otherwise
  2. PRISM Pediatric Risk of Mortality [27], NA not applicable
  3. aTime interval from onset of symptoms to hospital admission was available for 609/744 sepsis survivors and 33/51 non-survivors
  4. bPRISM score was available for 636/744 sepsis survivors and 36/51 non-survivors
  5. cPIM2 score was available for 645/744 sepsis survivors and 36/51 non-survivors. Data were log transformed for univariable and multivariable analysis
  6. dData on lactate at pediatric ICU admission were available for 421/744 sepsis survivors and 23/51 non-survivors. Data were log transformed for univariable analysis
  7. eBacterial etiology was confirmed in 428 patients, including 3 patients with mixed invasive pathogens in culture results: these 3 patients have been excluded, leaving 425 patients for analysis