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Observational Study
. 2019 Jun;117(3):S135-S156.
doi: 10.5546/aap.2019.eng.S135.

Epidemiological study of pediatric severe sepsis in Argentina

[Article in English, Spanish]
Roberto Jabornisky  1 , Silvia S Sáenz  2 , Patricia Capocasa  2 , Roxana Jaen  2 , Rodolfo P Moreno  2 , Luis Landry  2 , Daniel Rufach  2 , Silvia N Santos  2 , Mabel Berrueta  2 , Joseph Carcillo  3 , Juan Carlos Vassallo  2 ; Miembros del Grupo de Investigación Clínica y Epidemiológica en Terapia Intensiva Pediátrica de la Sociedad Argentina de Pediatría (SAP)
Affiliations
Free article
Observational Study

Epidemiological study of pediatric severe sepsis in Argentina

[Article in English, Spanish]
Roberto Jabornisky et al. Arch Argent Pediatr. 2019 Jun.
Free article

Abstract
in English, Spanish

Introduction: Severe sepsis (SS) is one of the leading causes of pediatric mortality in Argentina. The objective was to describe the epidemiological characteristics and to analyze risk factors associated with mortality from SS among patients hospitalized in pediatric intensive care units (PICU) in Argentina.

Population and methods: Observational, prospective cohort study among patients with SS hospitalized in PICUs in Argentina from 8/1/2008 to 9/30/2008.

Results: Two thousand five hundred and fifty nine patients were admitted at 59 PICUs. A total of 315 patients (335 events) were included. Patients' median age was 8 months (1-182). The frequency was 13.8 %, and 28-day mortality was 31.6 %. Patients with a higher mortality were those who were coming from rural areas, had comorbidities at the time of admission or a history of cancer, had shock or acute respiratory distress syndrome (ARDS), were administered low-dose corticosteroids or vasoactive drugs or more than 60 ml/kg of fluid in the first hour and in the first 6hours, and had severe malnutrition. Following adjustment by severity using a multivariate logistic regression model, only coming from a rural area, having shock or ARDS remained associated with 28-day mortality. Forty per cent of patients received antibiotics 60 minutes after diagnosis.

Conclusions: SS is an event with a high frequency and mortality in Argentina. In the severity adjusted multivariate analysis, only coming from a rural area, having ARDS and/or shock were associated with higher mortality.

Introducción. La sepsis grave (SG) es una de las principales causas de mortalidad pediátrica en Argentina. El objetivo fue describir las características epidemiológicas y analizar los factores asociados a la mortalidad de la SG en pacientes internados en unidades de cuidados intensivos pediátricos (UCIP) de Argentina. Pacientes y métodos. Estudio observacional, de cohorte prospectiva en pacientes con SG internados en UCIP de Argentina del 1/8/2008 al 30/9/2008. Resultados. En 59 UCIP, ingresaron 2559 pacientes. Se incluyeron 315 pacientes, que tuvieron 335 eventos. La mediana de edad fue 8 meses (1-182). La frecuencia fue del 13,8 % y la mortalidad a los 28 días, del 31,6 %. Tuvieron mayor mortalidad quienes procedían del ámbito rural, presentaban una comorbilidad al ingresar o antecedentes oncológicos, tenían shock o síndrome de dificultad respiratoria aguda (SDRA), recibieron corticoides en bajas dosis o drogas vasoactivas o más de 60 ml/kg de fluidos en la primera hora y en las 6 primeras horas, y los desnutridos graves. Al ajustarse por gravedad en un modelo de regresión logística multivariado, solo mantuvieron la asociación con mortalidad a los 28 días el provenir del ámbito rural, tener shock o SDRA. El 40 % de los pacientes recibieron antibióticos después de los 60 minutos del diagnóstico. Conclusiones. La SG es un evento de elevada frecuencia y mortalidad en Argentina. En el análisis multivariado ajustado por gravedad, solo provenir del área rural, la presencia de SDRA y/o de shock se asociaron a mayor mortalidad.

Keywords: critical care; fluid therapy; mortality; pediatrics; sepsis.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

References

    1. SAP-UNICEF. Salud Materno-infanto-juvenil 2017 en cifras. [Consulta: 25 de octubre de 2018]. Disponible en: http://www.sap.org.ar/uploads/archivos/files_2017-en-cifras_1505316814.pdf.
    1. Watson RS, Carcillo JA, Linde-Zwirble WT, Clermont G, et al. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2003; 167(5):695- 701.
    1. Jaramillo-Bustamante JC, Marín-Agudelo A, FernándezLaverde M, Bareño-Silva J. Epidemiology of sepsis in pediatric intensive care units: first Colombian multicenter study. Pediatr Crit Care Med. 2012; 13(5):501-8.
    1. Hartman ME, Linde-Zwirble WT, Angus DC, Watson RS. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med. 2013; 14(7):686-93.
    1. Weiss S, Fitzgerald JC, Pappachan J, Wheeler D, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med. 2015; 191(10):1147-57.

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