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A Controlled Mouse Model for Neonatal Polymicrobial Sepsis
Published on: January 27, 2019
Nested case-control study of multiple serological indexes and Brighton pediatric early warming score in predicting
Xiong Xie1, Ming Li2, Tian-Tian Xiong
1Tian-tian Xiong, Rui Wang, Liang Xiao, Department of Pediatrics, Third Clinical Hospital, China Three Gorges University, Gezhouba Central Hospital, Yichang 443002, Hubei Province, China.
Insights
Predicting childhood sepsis mortality is challenging. Combining serum procalcitonin (PCT), albumin (ALB), and Pediatric Early Warning Score (PEWS) offers the best accuracy for predicting outcomes in pediatric sepsis patients.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Biomarker research
Background:
- Early prediction of complications in pediatric sepsis remains a clinical challenge.
- The Brighton Pediatric Early Warning Score (PEWS) shows promise but single indicators are insufficient for assessing post-treatment status.
- Variability in pediatric indicators complicates sepsis management and prognosis assessment.
Purpose of the Study:
- To investigate the relationship between serological markers, Brighton PEWS, and mortality in children treated for sepsis.
- To identify independent risk factors for death in pediatric sepsis patients.
- To evaluate the combined predictive value of biomarkers and PEWS for sepsis prognosis.
Main Methods:
- A nested case-control study involving 205 children diagnosed with sepsis.
- Recording of baseline data, serum scores (including procalcitonin and albumin), and PEWS scores.
- Multivariate logistic regression analysis to identify influencing factors and predictive values for mortality.
Main Results:
- 96 children (48 deaths, 48 controls) were analyzed.
- Independent risk factors for sepsis-related death included: delayed antibacterial treatment, shock, MODS, elevated PCT, low ALB, and high PEWS.
- The combination of ALB, PCT, and PEWS achieved the highest predictive accuracy (AUC = 0.908).
Conclusions:
- Antibacterial treatment within 1 hour, shock, MODS, PCT, ALB, and PEWS are significant independent risk factors for pediatric sepsis mortality.
- The combined assessment of PCT, ALB, and PEWS provides the most accurate prediction of prognosis in children with sepsis.
Background:
Currently, it is difficult to predict the complications of children at the early stage of sepsis. Brighton pediatric early warning score (PEWS) is a disease risk assessment system that is simple and easy to operate, which has good sensitivity and specificity in disease recognition among children. Because detection indicators vary widely in children, a single indicator is difficult to assess the post-treatment status of children with sepsis.
Aim:
To investigate the relationship between serological markers, Brighton PEWS, and death in children with sepsis after treatment.
Methods:
A total of 205 children diagnosed with sepsis at our hospital were enrolled. The baseline data, serum scores, and PEWS scores were recorded. In the nested case-control study, children who died during the study period were included in an observation group. According to the matching principle, the children who were not dead in the same cohort were included in a control group. The influencing factors of death in children with sepsis after treatment and the value of each evaluation index in predicting the prognosis of children were analyzed.
Results:
A total of 96 children were enrolled in the study, including 48 each in the observation group and the control group. Multivariate logistic regression analysis indicated that antibacterial treatments within 1 h (P = 0.017), shock (P = 0.044), multiple organ dysfunction syndrome (MODS) (P = 0.027), serum procalcitonin (PCT) (P = 0.047), serum albumin (ALB) (P = 0.024), and PEWS (P = 0.012) were independent risk factors for the death of children with sepsis. The area under the curve of the combination of ALB, PCT, and PEWS to predict the death in children with sepsis was the highest (0.908).
Conclusion:
Antibacterial treatments within 1 h, shock, MODS, PCT, ALB, and PEWS are independent risk factors for the death of children with sepsis. The predictive accuracy of the combination of PCT, ALB, and PEWS for the prognosis of children with sepsis is the best.
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