Epidemiology and outcomes of septic shock in children with complex chronic conditions in a developing country PICU

Rech, Leandra; Sousa, Ian Teixeira e; Tonial, Cristian Tedesco; Piva, Jefferson Pedro

doi:10.1016/j.jped.2022.03.005

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…Research by Rech et al found that comorbidities can worsen the prognosis of septic shock patients admitted to the PICU. In that study it was said that patients with comorbidities had 3.4-fold risk of death compared to those without comorbidities (OR = 3.4; 95% CI 1.3 -8.4) [20]. This is similar to the research conducted by Ruth et al who found that patients with comorbidities had risk of death 1.4 times in severe sepsis (OR = 1.49; 95% CI 1.35 -1.64) [21].…”

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confidence: 95%

Relationship between serum ferritin level and outcome of septic shock in children

Dewa Ayu Angga Rainingsih,

I Made Gede Dwi Lingga Utama,

Ida Bagus Gede Suparyatha

et al. 2023

GSC Adv. Res. Rev.

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Background Sepsis is a life-threatening organ dysfunction caused by dysregulation of the immune system against infection. Sepsis that leads to septic shock is one of the causes of morbidity and mortality in children who are treated in intensive care and inpatient rooms. Ferritin is a protein whose synthesis is increased in inflammatory and infectious conditions and can be a marker of active infection. The cut off ferritin in septic shock was not established and not absolutely clear in our patients. Objective To determine the cut-off value of ferritin levels in patient with septic shock and the relationship between high serum ferritin levels with poor outcome (mortality) in pediatric patients with septic shock. Methods This study used an observational-analytic design with prospective cohort study design. The research was conducted in pediatric ward, Prof. Dr. I.G.N.G. Ngoerah hospital from October 2021 to August 2022. Data analysis was done in 2 steps, first by using receiver operator characteristic curves to find the optimal cut-off point value and the second step was bivariate and multivariate analysis to determine the relationship between ferritin levels and the outcome of septic shock in children. The significance level (α) of this study was set with probability value less than 0.05. Results This study involved 76 subjects, 49 subjects died and 27 subjects survive. The Area Under Curve of ferritin levels from ROC curve obtained was 83.7% (p=0.001, 95% CI 74.2%-93.1%). The cut off for ferritin level 660.78 ng/ml gave sensitivity 85.7% and specificity 77.8% for mortality in patients with septic shock. The value of ferritin levels ³ 660.78 generate mortality risk 39.50 times (95% CI 8.057 – 183.422) in pediatric patients with septic shock. Conclusion Higher ferritin levels can increase the risk of mortality in pediatric septic shock patients.

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Section: Figure 2 Roc Curvementioning

confidence: 95%

Relationship between serum ferritin level and outcome of septic shock in children

Dewa Ayu Angga Rainingsih,

I Made Gede Dwi Lingga Utama,

Ida Bagus Gede Suparyatha

et al. 2023

GSC Adv. Res. Rev.

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Changes in the Number of Children and Adolescents with Complex Chronic Conditions and Medical Spending: Analyzing National Health Insurance Claims Data from 2011 to 2021

Oh,

Cho,

Jung

et al. 2023

HIRA Research

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Background:The number of children and adolescents has decreased by more than 3 million over the past 10 years. We analyzed changes in the number of children and adolescents with complex chronic conditions (CCCs) and their medical expenditures between 2011 and 2021. Methods: We used National Health Insurance claims data of patients under the age of 20 from 2011 to 2021. CCCs were classified as pediatric CCCs by Feudtner et al. Patients who repeatedly utilize medical services due to CCCs were defined as patients who sought medical care twice or more within the past 3 years. Their sex, age, CCC categories, and the number of CCC categories were presented using descriptive analyses. Results: The number of children and adolescents with CCCs increased from 345,320 (3.04%) in 2011 to 451,238 (5.33%) in 2021. Patients who repeatedly utilized medical services due to CCCs increased by 71,889 during the same period. The proportion of patients with two or more CCC categories increased from 35.80% in 2011 to 43.67% in 2021. In 2021, patients with other congenital or genetic defect were most common. Medical expenditures associated with CCCs increased from 475,654 million won (12.34%) in 2011 to 768,467 million won (19.11%) in 2021. Conclusion:The number of patients with CCCs and their medical expenditures increased in Korea between 2011 and 2021. The results indicate that consistent national efforts are required to maintain the specialized pediatric care. Further studies are needed to identify pediatric patients who require specialized medical services through various methods.

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Epidemiology and outcomes of septic shock in children with complex chronic conditions in a developing country PICU

Cited by 2 publications

References 20 publications

Relationship between serum ferritin level and outcome of septic shock in children

Relationship between serum ferritin level and outcome of septic shock in children

Changes in the Number of Children and Adolescents with Complex Chronic Conditions and Medical Spending: Analyzing National Health Insurance Claims Data from 2011 to 2021

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