Faktor Risiko yang Berperan pada Mortalitas Sepsis

Saraswati, Desy Dewi; Pudjiadi, Antonius Hocky; Djer, Mulyadi M.; Supriyatno, Bambang; Syarif, Damayanti R.; Kurniati, Nia

doi:10.14238/sp15.5.2014.281-8

Cited by 18 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This difference may have been due to their larger sample size of 209 subjects. 8 The PELOD-2 score analysis was also in line with…”

Section: Discussionsupporting

confidence: 60%

Triiodothyronin (T3) as a parameter of mortality in sepsis patients in the PICU

Djoko¹,

Hartawan²,

Arhana³

et al. 2019

View full text Add to dashboard Cite

Background Thyroid hormone stimulates the regulation of β-adrenergic receptors in order to increase the inotropic effect of the heart myocardium. Euthyroid sick syndrome is a disorder of non-metabolic thyroid function, which is characterized by a decrease in triiodothyronine (T3) levels in patients with non-thyroid systemic disease, such as sepsis. Low serum T3 hormone level is a potentially high-risk factor for mortality from sepsis. Objective To assess for a relationship between decreased serum T3 levels and mortality in pediatric sepsis patients admitted in the PICU. Methods This study used a nested case-control design. The subjects were children aged 1 month-18 years who were diagnosed with sepsis in the pediatric intensive care unit at Sanglah Hospital, Denpasar, Bali, from September 2017 to January 2019. Results A total of 90 children were included, of whom 44 died and 46 survived. Median age was 10.5 (IQR 44) months in subjects who died and 9 (IQR 50) months in those who survived. The majority of subjects in both groups had well-nourished nutritional status. Bivariate analysis revealed that significantly more subjects who died had low serum T3 (≤1 ng/dL), PELOD-2 score ≥5, than subjects who survived. Multivariate analysis revealed that serum T3 £1 ng/dL (OR 55.1; 95%CI 9 to 334.8; P<0.001) and PELOD-2 score ³5 (OR 6.5; 95%CI 1.6 to 26.7; P=0.01) were significant risk factors for sepsis mortality. Conclusion Low serum T3 level and high PELOD-2 score are risk factors for death in sepsis.

show abstract

“…This difference may have been due to their larger sample size of 209 subjects. 8 The PELOD-2 score analysis was also in line with…”

Section: Discussionsupporting

confidence: 60%

Triiodothyronin (T3) as a parameter of mortality in sepsis patients in the PICU

Djoko¹,

Hartawan²,

Arhana³

et al. 2019

View full text Add to dashboard Cite

show abstract

“…A study in Jakarta stated the same results, which analyzed mortality in pediatric patients with sepsis and found out that the median age of subjects was 15 months (range 2-192) with the highest distribution in the 1 month -1 year age group (62%). 11 Younger age has been associated with immune system immaturity and is usually accompanied by comorbidities, such as congenital heart disease and kidney disease, thus the incidence of infections that cause sepsis is a factor that increases the risk of mortality. 1,[11][12][13] Also, the Sepsis Prevalence, Outcomes, and Therapies Study (SPROUT) conducted in 128 PICUs in 26 countries revealed that patients who met SIRS-severe sepsis criteria based on international consensus had a mean age of 3 years, and the foci of infection were the respiratory system (40%) and bacteremia (19%).…”

Section: Discussionmentioning

confidence: 99%

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Wulandari¹,

Pudjiastuti²,

Martuti³

2019

View full text Add to dashboard Cite

Background Sepsis is one of the main causes of death in infants and children. Currently, it is defined as a life-threatening organ dysfunction, caused by an inflammatory response of infection. Several organ dysfunction assessment methods are available, but they are not uniformly used. Objective To compare the accuracy of three mortality predictor tools: severe sepsis criteria, pediatric logistic organ dysfunction (PELOD)-2, and pediatric sequential organ failure assessment (pSOFA), in critically ill children with sepsis. Methods This prospective cohort study was conducted in the pediatric intensive care unit (PICU) and pediatric high care unit (HCU) of dr. Moewardi Hospital, Surakarta, Central of Java. All patients who met the systemic inflammatory response syndrome (SIRS) criteria were included in our study. The exclusion criteria were congenital anomalies of heart or kidney, malignancy, or hematological abnormalities. The data were taken from laboratory and physical examinations by the physicians on duty. The outcome assessed was mortality. Results Of 30 subjects, the mean age was 22.22 (SD 29.36) months; the most common infection source was the respiratory tract, followed by gastrointestinal tract and central nervous system. Most subjects were treated in the PICU and had a mean length of stay of 8.70 (SD 11.91) days. Severe sepsis and PELOD-2 were not significant predictors of death. However, pSOFA score was a statistically significant predictor of mortality, with odds ratio 10.11 (95%CI 1.054 to 97.002; P=0.039). Conclusion Pediatric SOFA (pSOFA) is a better predictor of mortality compared to PELOD-2 and SIRS-severe sepsis. A pSOFA score ≥ 2 increases the risk of mortality by 10.11-fold.

show abstract

“…Saraswati et al showed that subjects with PELOD scores ≥ 20 had a 39.08 times higher mortality risk than subjects with PELOD score < 20. 17 In our study,of the 92 patients who underwent lactate examinations, only 58 had the complete examination data required to calculate PELOD scores. We found no association between PELOD score and lactate level in shock patients ( Table 4), similar to a study by Ismyet al 18 Therefore, lactate level didn't affect the severity of sepsis marked by PELOD scores.…”

Section: Discussionmentioning

confidence: 99%

Lactate profiles of pediatric shock patients in Cipto Mangunkusumo General Hospital 2015: a pilot study

Yuniar

2017

View full text Add to dashboard Cite

Background The 2015 Surviving Sepsis Campaign (SSC) guidelines for management of shock recommend blood lactate to assess the success of resuscitation in shock. However, a study in adults found that 1/3 of septic shock patients had normal lactate levels (alactatemia) and lower mortality rates. Objective To evaluate lactate profiles, possible factors affecting lactate levels, and mortality outcomes in pediatric shock patients in the emergency room (ER) and pediatric intensive care unit (PICU). Methods This was a retrospective study on pediatric shock patients aged 1 month to 18 years in the ER or PICU from June 2014 to December 2015. Data were taken from subjects' medical records including lactate levels, examination data required to calculate a PELOD score, and mortality outcomes. Results Of 223 shock patients evaluated, only 92 cases (41.2%) underwent lactate examinations. Of these, 59 (64.1%) had alactatemia and 33 (35.9%) had hyperlactatemia. A total of 23.7% of the alactatemia group and 36.4% of the hyperlactatemia group died, thus, the initial lactate level was not significantly associated with patient outcomes (P=0.197). The mortality rates of patients with <10% and ≥10% lactate clearance were 31.3% and 17.6%, respectively (P=0.362). Conclusion In alactatemia patients, lactate level can not be used as a goal for resuscitation. Further study is needed to find a biomarker for assessing the success of pediatric shock resuscitation. Moreover, the clinical relevance of alactatemia is uncertain in pediatric shock patients

show abstract

Faktor Risiko yang Berperan pada Mortalitas Sepsis

Cited by 18 publications

References 14 publications

Triiodothyronin (T3) as a parameter of mortality in sepsis patients in the PICU

Triiodothyronin (T3) as a parameter of mortality in sepsis patients in the PICU

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Lactate profiles of pediatric shock patients in Cipto Mangunkusumo General Hospital 2015: a pilot study

Contact Info

Product

Resources

About