• Jhuma Sankar, Sheetal Agarwal, Anshu Goyal, S K Kabra, and Rakesh Lodha.
• Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
• Pediatr Crit Care Me. 2024 Apr 1; 25 (4): e186e192e186-e192.

ObjectivesTo describe mortality associated with different clinical phenotypes of sepsis in children.DesignRetrospective study.SettingPICU of a tertiary care center in India from 2017 to 2022.PatientsSix hundred twelve children (from 2 mo to 17 yr old) with a retrospectively applied diagnosis of sepsis using 2020 guidance.MethodsThe 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.InterventionsNone.Measurements And ResultsOf 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.ConclusionsIn 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.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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