Risk factors for sepsis-related death in children and adolescents with hematologic and malignant diseases

Sano, Hirozumi; Kobayashi, Ryōji; Iguchi, Akihiro; Suzuki, Daisuke; Kishimoto, Kenji; Yasuda, Kazue; Kobayashi, Kunihiko

doi:10.1016/j.jmii.2015.04.002

Cited by 17 publications

(14 citation statements)

References 27 publications

(27 reference statements)

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“…[22–25] The role of CRP and PCT as potential biomarkers for infection has been unclear since earlier studies showed inconsistent results. [20,21,26,27] In our study, we found no association between CRP and PCT and sepsis-related mortality in pediatric patients. This lack of association could have been because all study participants suffered from severe infections.…”

Section: Discussioncontrasting

confidence: 59%

Development and validation of a mortality risk model for pediatric sepsis

Chen

et al. 2017

Medicine

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Pediatric sepsis is a burdensome public health problem. Assessing the mortality risk of pediatric sepsis patients, offering effective treatment guidance, and improving prognosis to reduce mortality rates, are crucial.We extracted data derived from electronic medical records of pediatric sepsis patients that were collected during the first 24 hours after admission to the pediatric intensive care unit (PICU) of the Hunan Children's hospital from January 2012 to June 2014. A total of 788 children were randomly divided into a training (592, 75%) and validation group (196, 25%). The risk factors for mortality among these patients were identified by conducting multivariate logistic regression in the training group. Based on the established logistic regression equation, the logit probabilities for all patients (in both groups) were calculated to verify the model's internal and external validities.According to the training group, 6 variables (brain natriuretic peptide, albumin, total bilirubin, D-dimer, lactate levels, and mechanical ventilation in 24 hours) were included in the final logistic regression model. The areas under the curves of the model were 0.854 (0.826, 0.881) and 0.844 (0.816, 0.873) in the training and validation groups, respectively.The Mortality Risk Model for Pediatric Sepsis we established in this study showed acceptable accuracy to predict the mortality risk in pediatric sepsis patients.

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Section: Discussioncontrasting

confidence: 59%

Development and validation of a mortality risk model for pediatric sepsis

Chen

et al. 2017

Medicine

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“…The results of the study above indicated that more than half (52.9%) of the isolates from sepsis-related death belonged to Gram-positive cocci resistant to β-lactam antibiotics. In mentioned study, it has been revealed that relapse history, history of the underlying disease, and high C reactive protein concentration at the onset of fever could be a key factor for mortality in patients with sepsis [ 16 ]. Sepsis is the leading cause of 5.6% of deaths in adult patients with trauma, but about 33% of brain damage has been shown a safe interrupt the neural axis.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Risk Factors for the Development of Bacteraemia in Children

Mojtahedi¹,

Rahbarimanesh²,

Khedmat³

et al. 2018

Open Access Maced J Med Sci

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AIM:The objective of this study was to evaluate the frequency of risk factors for bacteremia in children less than 15 years of age was determined in Bahrami Hospital during 2013-2016.METHODS:This study conducted on 84 children aged 3 months’ to15 years old, who hospitalised in the pediatrics ward and the PICU in Bahrami Hospital from 2012 to 2016. Our study consisted of 46 boys (54.2%) and 38 girls. Moreover, 24.1% of subjects (20 patients) were entered in the study as young as three months old, followed by three months to three years (49.4 %; 41 subjects), and 3 to 15 years of age (26.5%; 22 individuals).RESULTS:The average hospitalization duration was determined to be 15.30 ± 8.75 days. Moreover, our results revealed that a history of blood transfusion in 11.2% of patients. On the other hand, 35.7% of cases were determined to be positive for blood cultures. The microorganisms reported from positive blood cultures include Enterobacter (81.48%), Escherichia coli (11.11%) and Klebsiella (3.70%). Also, 50% of patients were hospitalised in the internal ward, 12% received immunosuppressive drugs, and 96.4% of the patients had a history of vaccination.CONCLUSION:Pediatric severe sepsis remains a burdensome public health problem, with prevalence, morbidity, and mortality rates similar to those reported in critically ill adult populations. International clinical trials targeting children with severe sepsis are warranted.

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“…There was a marked predominance of the male gender (2.3: 1), which surpasses what was previously reported in international and national studies. [12][13][14] The mean age was 7.6 years, higher than the study by Hakim et al, 15 whose patients averaged 5.9 years, but less than the cohort of Vázquez et al, 16 in Mexico, where it was 8.3 years.…”

Section: Discussionmentioning

confidence: 75%

“…The other isolated bacteria, with the exception of S. thoralensis (which has not been identified in other series), have a comparable frequency. 12,13,16,21 The time between the onset of fever and the administration of antibiotics had a median of five hours, significantly higher than what the current IDSA guideline recommends (<2 hours). 8 Cox et al, found that in their emergency department, 53% of patients received antibiotics during the first two hours of fever onset; only 5% of their patients took between 240-299 minutes to start treatment.…”

Section: Discussionmentioning

confidence: 97%

Management of febrile neutropenia in pediatric cancer patients

Acosta¹

2019

JPNC

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Introduction: Febrile neutropenia (FN) is the most common complication that threatens the life of patients undergoing chemotherapy. It is considered an oncological emergency and its therapeutic decisions must be timely and accurate. Objective: To evaluate the therapeutic approach given to pediatric cancer patients with episodes of neutropenia and fever. Material and methods: Descriptive, observational, cross-sectional and retrospective study in children with acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), Burkitt's lymphoma (BL) and lymphoblastic lymphoma (LL) who attended the hematology service from 2014 to 2018. Age, gender, underlying diagnosis, treatment phase, absolute neutrophil count, clinical manifestations, blood culture collection and results, initial antimicrobial therapy, treatment changes, complications, days of hospital stay and mortality were analyzed. Descriptive statistics was used, with measures of central tendency, percentages and frequencies with the SPSS v22 program. Results: We identified 104 episodes of FN in 70 patients with cancer. The mean age was 7 years and majority of patients were male (n=49, 70.0%). ALL was the most frequent underlying malignancy (n=59, 84.3%) and the highest amount of FN episodes occurred during the induction phase (n=74, 71.2%). Fever of unknown origin was observed in 29 (27.9%) episodes. Blood cultures were collected in 14 (13.5%) cases. The most commonly isolated microorganisms in blood culture were Gram-positive bacteria (n=10, 76.9%). β-lactams and aminoglycosides were the most common antibiotics used. Conclusions: Febrile neutropenia is a frequent complication in the pediatric population with hemato-oncological diseases in our hospital. The therapeutic approach that patients receive is adequate.

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Risk factors for sepsis-related death in children and adolescents with hematologic and malignant diseases

Cited by 17 publications

References 27 publications

Development and validation of a mortality risk model for pediatric sepsis

Development and validation of a mortality risk model for pediatric sepsis

The Prevalence of Risk Factors for the Development of Bacteraemia in Children

Management of febrile neutropenia in pediatric cancer patients

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