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Pediatric Shock: The Magnitude, Its Determinants and Short-Term Outcome on Patients. A Cross-Sectional Hospital-Based
Mebrahtu Gebreslassie Kidanu1, Engdaeshet Tazebe2, Alemseged Berhane Tesfa2
1Department of Pediatrics and Child Health, Aksum University, Aksum, Tigray, Ethiopia.
Insights
Pediatric shock is a critical condition in children, leading to high mortality rates in Ethiopia. Early detection and treatment are crucial for improving outcomes in pediatric shock patients.
Area of Science:
- Pediatric critical care
- Emergency medicine
- Public health in developing countries
Background:
- Pediatric shock, a systemic circulatory failure in children, is a life-threatening emergency.
- High morbidity and mortality associated with pediatric shock necessitate early identification and treatment.
- Limited data exists on the extent and causes of shock-related mortality in Ethiopian children.
Purpose of the Study:
- To evaluate the magnitude of pediatric shock.
- To identify determinants and risk factors associated with pediatric shock.
- To assess the short-term outcomes of pediatric shock at a tertiary hospital in Ethiopia.
Main Methods:
- An observational, cross-sectional study was conducted from October 2020 to July 2022.
- 132 pediatric patients (1 month to 18 years) diagnosed with shock according to guidelines were included.
- Bivariate logistic regression analysis was used to identify predictors of mortality.
Main Results:
- The prevalence of shock was 2.2%, with 70.5% presenting in a decompensated stage.
- The mortality rate for pediatric shock was 45.5%.
- Delayed presentation, non-hypovolemic shock types, advanced shock stage, mechanical ventilation, and short hospital stay (<3 days) predicted mortality.
Conclusions:
- Pediatric shock is associated with a high mortality rate in the studied Ethiopian population.
- Key predictors of mortality include delayed presentation, shock type, shock stage, mechanical ventilation, and brief hospital stay.
- Urgent interventions and improved access to care are critical for reducing pediatric shock mortality.
Background:
Pediatric shock is a potentially fatal illness which develops after a systemic circulatory system failure in children. It appears to be a common emergency in children and produces substantial morbidity and mortality particularly if there is no early identification and therapy. The extent and causes of shock-induced death among children in Ethiopia have not been sufficiently studied.
Objective:
This study was conducted to evaluate the magnitude, determinants and short-term outcome of shock in pediatric patients who visited Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia.
Methods:
From October 1, 2020, to July 30, 2022, an observational cross-sectional study was carried out at Ayder Comprehensive Specialized Hospital. The study included 132 children from the age of 1 month to 18 years. According to pediatric advanced life support guidelines, shock was diagnosed among patients. To gather information, a pretested questionnaire was employed. To examine the relationship between the independent variables and shock outcome, bivariate logistic regression was performed, and statistical significance was defined as a P-value of 0.05 or lower.
Results:
The prevalence of shock was 2.2%. This study revealed 70.5% decompensated stage of shock. Mortality rate of shock was 45.5% (95% CI: 37.1-53.8). A delayed presentation by more than one week with an adjusted odd ratio (AOR) of 16.9 (95% CI: 2.3-123), type of shock other than hypovolemic shock with AOR of 8.3 (95% CI: 1.4-48), stage of shock with AOR of 27.8 (95% CI: 2.8-157), requirement of mechanical ventilation with AOR of 11 (95% CI: 2.6-53) and length of hospital stay less than three days with AOR of 9 (95% CI: 1.7-48) were identified as a predictor of mortality by shock in children.
Conclusion:
According to this study, shock causes a high rate of child mortality. Independent predictors of mortality included delayed presentation, shock type, stage of shock, the need for mechanical ventilation, and brief hospital stay (less than three days).
