• David Vila Pérez, Iolanda Jordan, Elisabeth Esteban, Patricia García-Soler, Vega Murga, Vanesa Bonil, Irene Ortiz, Carlos Flores, Amaya Bustinza, and Francisco Jose Cambra.
• From the *Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona; †Pediatric Intensive Care Unit Service, Hospital Carlos Haya, Málaga; ‡Pediatric Intensive Care Unit Service, Hospital Universitario de Salamanca, Salamanca; §Pediatric Intensive Care Unit Service, Hospital Parc Taulí, Sabadell; ¶Pediatric Intensive Care Unit Service, Hospital Virgen de la Salud, Toledo; ‖Pediatric Intensive Care Unit Service, Hospital Puerta del Mar, Cádiz; and **Pediatric Intensive Care Unit Service, Hospital Gregorio Marañón, Madrid, Spain.
• Pediatr. Infect. Dis. J. 2014 Feb 1;33(2):152-7.

BackgroundSepsis and septic shock represent up to 30% of admitted patients in pediatric intensive care units, with a mortality that can exceed 10%. The objective of this study is to determine the prognostic factors for mortality in sepsis.MethodsMulticenter prospective descriptive study with patients (aged 7 days to 18 years) admitted to the pediatric intensive care units for sepsis, between January 2011 and April 2012.ResultsData from 136 patients were collected. Eighty-seven were male (63.9%). The median age was a year and a half (P25-75 0.3-5.5 years). In 41 cases (30.1%), there were underlying diseases. The most common etiology was Neisseria meningitidis (31 cases, 22.8%) followed by Streptococcus pneumoniae (16 patients, 11.8%). Seventeen cases were fatal (12.5%). In the statistical analysis, the factors associated with mortality were nosocomial infection (P = 0.004), hypotension (P <0.001) and heart and kidney failure (P < 0.001 and P = 0.004, respectively). The numbers of leukocytes, neutrophils and platelets on admission were statistically lower in the group that died (P was 0.006, 0.013 and <0.001, respectively). Multivariate analysis showed that multiple organ failure, neutropenia, purpura or coagulopathy and nosocomial infection were independent risk factors for increased mortality (odds ratio: 17, 4.9, 9 and 9.2, respectively).ConclusionsPatients with sepsis and multiorgan failure, especially those with nosocomial infection or the presence of neutropenia or purpura, have a worse prognosis and should be monitored and treated early.

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