Related Experiment Video
Updated: May 6, 2026
A Controlled Mouse Model for Neonatal Polymicrobial Sepsis
Published on: January 27, 2019
Pediatric Sepsis Phenotypes and Outcome: 5-Year Retrospective Cohort Study in a Single Center in India (2017-2022)
Jhuma Sankar1, Sheetal Agarwal, Anshu Goyal
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Pediatric sepsis phenotypes with multiple organ failure (MOF) significantly increase mortality risk and resource needs. Identifying these severe sepsis cases is crucial for better outcomes.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Clinical epidemiology
Background:
- Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Clinical phenotypes of pediatric sepsis vary, impacting patient outcomes and resource utilization.
- Accurate classification of sepsis phenotypes is essential for targeted management and prognosis.
Purpose of the Study:
- To characterize mortality rates across different clinical phenotypes of pediatric sepsis.
- To identify risk factors and resource requirements associated with distinct sepsis subtypes.
- To evaluate the association between multiple organ failure (MOF) and sepsis outcomes in children.
Main Methods:
- Retrospective study conducted at a tertiary care center in India (2017-2022).
- Included 612 children (2 months to 17 years) diagnosed with sepsis based on 2020 guidelines.
- Analyzed mortality, organ support needs, and PICU resource utilization by sepsis phenotype, including MOF and thrombocytopenia-associated MOF (TAMOF).
Main Results:
- Sepsis phenotypes with MOF, including TAMOF and sequential MOF (SMOF), showed significantly higher mortality (42-50%) compared to sepsis without MOF (21%).
- Elevated lactate levels and the presence of MOF were independently associated with increased odds of mortality.
- All MOF phenotypes required greater organ support and PICU resources than non-MOF sepsis.
Conclusions:
- In Indian children, sepsis phenotypes involving MOF are strongly linked to increased mortality and higher PICU resource demands.
- The findings underscore the critical impact of MOF on pediatric sepsis outcomes.
- Further prospective, multi-regional studies are needed to refine pediatric sepsis classification for broader applicability.
Objectives:
To describe mortality associated with different clinical phenotypes of sepsis in children.
Design:
Retrospective study.
Setting:
PICU of a tertiary care center in India from 2017 to 2022.
Patients:
Six hundred twelve children (from 2 mo to 17 yr old) with a retrospectively applied diagnosis of sepsis using 2020 guidance.
Methods:
The main outcome was mortality associated with sepsis subtypes. Other analyses included assessment of risk factors, requirement for organ support, and PICU resources used by sepsis phenotype. Clinical data were recorded on a predesigned proforma.
Interventions:
None.
Measurements And Results:
Of the 612 children identified, there were 382 (62%) with sepsis but no multiple organ failure (NoMOF), 48 (8%) with thrombocytopenia-associated MOF (TAMOF), 140 (23%) with MOF without thrombocytopenia, and 40 (6.5%) with sequential MOF (SMOF). Mortality was higher in the SMOF (20/40 [50%]), MOF (62/140 [44%]) and TAMOF (20/48 [42%]) groups, compared with NoMOF group (82/382 [21%] [ p < 0.001]). The requirement for organ support and PICU resources was higher in all phenotypes with MOF as compared with those without MOF. On multivariable analysis elevated lactate and having MOF were associated with greater odds of mortality.
Conclusions:
In this single-center experience of sepsis in India, we found that sepsis phenotypes having MOF were associated with mortality and the requirement of PICU resources. Prospective studies in different regions of the world will help identify a classification of pediatric sepsis that is more widely applicable.
Related Concept Videos
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Bacterial Meningitis II: Pathophysiology