Outcomes associated with septic shock at admission in a pediatric intensive cara unit
DOI:
https://doi.org/10.5433/anh.2025v7.id49796Keywords:
Intensive Care Units Pediatric, Shock Septic, Respiration Artificial, Cardiovascular Agents, Hospital MortalityAbstract
Objective: o analyze the association between the diagnosis of septic shock at admission and negative outcomes in a Pediatric Intensive Care Unit (PICU) in Southern Brazil. Methods: This was a retrospective cohort study of hospital admissions of children aged 0 to 15 years between 2012 and 2017. The dependente variable was septic shock at admission. The outcomes included fasting at admission, diagnosis of healthcare- associated infections (HAI), length of stay in the PICU, and death. Poisson regression with robust variance was performed using the Statistical Package for Social Sciences (SPSS®), with progressive adjustment for demographic and clinical variables. Relative risk (RR) and 95% confidence intervals (CI) were calculated, with a significance level of 5%. Results: Of the 1.068 admissions analyzed, 112 (10.5%) had a diagnosis of septic shock at admission. A significant portion of these patients came from other municipalities (73.2%, p=0.023), and higher proportions of invasive mechanical ventilation (92.9%, p<0.001) and vasoactive drug use (83.0%, p<0.001) were observed in this population. Septic shock was a risk factor for prolonged fasting after admission (RR=1.14; 95% CI: 1.07-1.21) and for the acquisition of HAI (RR=1.67; 95% CI: 1.29- 2.17). It was also associated with a longer stay in intensive care (RR=1.3; 95% CI: 1.09-1.56), with a median stay of four days, and a higher risk of death (RR=5.76; 95% CI: 4.39-7.55). Conclusion: Recognizing the characteristics of children admitted with septic shock allows for the identification of the patient profile at higher risk of unfavorable outcomes.
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