Estudio epidemiológico de sepsis grave pediátrica en la República Argentina

Abstract

Introduction: Severe sepsis (SS) is one of the leading causes of pediatric mortality in Argentina. The objective was to describe the epidemiological characteristics and to analyze risk factors associated with mortality from SS among patients hospitalized in pediatric intensive care units (PICU) in Argentina.

Population and methods: Observational, prospective cohort study among patients with SS hospitalized in PICUs in Argentina from 8/1/2008 to 9/30/2008.

Results: Two thousand five hundred and fifty nine patients were admitted at 59 PICUs. A total of 315 patients (335 events) were included. Patients' median age was 8 months (1-182). The frequency was 13.8 %, and 28-day mortality was 31.6 %. Patients with a higher mortality were those who were coming from rural areas, had comorbidities at the time of admission or a history of cancer, had shock or acute respiratory distress syndrome (ARDS), were administered low-dose corticosteroids or vasoactive drugs or more than 60 ml/kg of fluid in the first hour and in the first 6hours, and had severe malnutrition. Following adjustment by severity using a multivariate logistic regression model, only coming from a rural area, having shock or ARDS remained associated with 28-day mortality. Forty per cent of patients received antibiotics 60 minutes after diagnosis.

Conclusions: SS is an event with a high frequency and mortality in Argentina. In the severity adjusted multivariate analysis, only coming from a rural area, having ARDS and/or shock were associated with higher mortality.