Mortality Prediction in Pediatric Patients with Sepsis of Abdominal Origin: A Retrospective Study

Abstract

Aims: The aim of this study was to assess the prediction of mortality in pediatric patients with sepsis of abdominal origin. Methods: We performed a retrospective study of patients with sepsis of abdominal origin admitted to the pediatric intensive care unit (PICU) in Shanghai Children’s Hospital between May 2014 and April 2018. Results: A total of 143 patients were enrolled in this study. The mortality rate in pediatric patients with sepsis of abdominal origin was 11% (17/143). PRISMIII score, the grade of acute gastrointestinal injury (AGI), hematologic malignancy, acute kidney injury, the initial number of organ dysfunction, alanine aminotransferase (ALT), and blood platelet (PLT) were potential risk factors for increased mortality. Multivariate logistic regression analysis indicated that higher Pediatric risk of mortality III (PRISM III) score and the grade of AGI were independent risk factors of mortality in patients with sepsis of abdominal origin. Furthermore, the area under receiver-operating characteristic (ROC) curve (AUC) for PRISM III score and the grade of AGI were 0.91 (95% confidence interval (CI) 0.86–0.96, P<0.001) and 0.83 (95% CI 0.74–0.92, P<0.001), in which the optimal cut-off value was 10.5 and 2.5, respectively. In addition, the Kaplan-Meier curve indicated that the 28-day survival rate was significantly lower in patients with higher PRISM III score (>10.5) and the grade of AGI (>2.5). Conclusions: Higher PRISM III score and the grade of AGI were associated with poor outcomes in pediatric patients with sepsis of abdominal origin.