• David Vila Pérez, Iolanda Jordan Garcia, Elisabeth Esteban Torne, Patricia García-Soler, Vega Murga, Vanesa Bonil, Irene Ortiz, Carlos Flores, Amaya Bustinza, and Cambra Lasaosa.
• 1 Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. 2 Pediatric Intensive Care Unit Service, Hospital Carlos Haya, Málaga, Spain. 3Pediatric Intensive Care Unit Service, Hospital Universitario de Salamanca, Spain. 4Pediatric Intensive Care Unit Service, Hospital Parc Taulí, Sabadell, Spain. 5Pediatric Intensive Care Unit Service, Hospital Virgen de la Salud, Toledo, Spain. 6Pediatric Intensive Care Unit Service, Hospital Puerta del Mar, Cádiz, Spain. 7Pediatric Intensive Care Unit Service, Hospital Gregorio Marañón, Madrid, Spain.
• Pediatr. Infect. Dis. J. 2013 Sep 20.

Introduction:Sepsis and septic shock represent up to 30% of admitted patients in paediatric intensive care units (PICU), with a mortality that can exceed 10%.Objectives:To determine the prognostic factors for mortality in sepsis.Patients And Methods:Multicenter prospective descriptive study with patients (aged 7 days to 18 years) admitted to the PICU for sepsis, between January 2011 and April 2012.Results:Data 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 aetiology was N. meningitidis (31 cases, 22.8%) followed by S. 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 of 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 (OR 17, 4.9, 9, 9.2, respectively).Conclusions:Patients 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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