Article Sidebar

Submitted
5 August 2019
Accepted
20 October 2022
Published
5 December 2022
Download
pdf
Statistic
Read Counter : 588 Download : 235

Main Article Content

Abstract

Highlight:



  1. Sepsis and septic shock cause morbidity and mortality in pediatric patients.

  2. The accuracy of pediatric sequential organ failure assessment and anion gap (pSOFA+AG) was compared with AG and pediatric logistic organ dysfunction-2 (AG+PELOD-2).

  3. The mortality assessment of pediatric septic patients showed that pSOFA was more sensitive than PELOD-2, while pSOFA+AG was not more sensitive than PELOD-2.


 


Abstract:


Sepsis and septic shock are some of the causes of morbidity and mortality (50-60%) in pediatric patients treated in intensive care rooms. This study aimed to compare the accuracy of pediatric Sequential Organ Failure Assessment (pSOFA) score combined with anion gap (AG) score to Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score in the assessment of mortality in pediatric septic patients at the Resuscitation Room of Dr. Soetomo Geeneral Academic Hospital, Surabaya, Indonesia. This was a retrospective observational cohort study using pediatric sepsis diagnosis guidelines based on the 2016 Pediatric Sepsis Consensus and medical records between January-December 2018. All data of patients aged 1 month to 16 years with suspected infection at the Resuscitation Room were collected based on predisposing infections, signs of infection, and warning signs. Organ dysfunction was assessed by calculating the pSOFA+AG scores, PELOD-2 scores, and corrected anion gap (cAG) in the first 24 hours. Sepsis mortality was assessed by comparing the results of the pSOFA, pSOFA+AG, and PELOD-2. The results showed 94.9% sensitivity and 70.0% specificity (p<0.0001) in the pSOFA, 89.9% sensitivity and 71.3% specificity (p<0.0001) in the PELOD-2, 79.7% sensitivity and 65% specificity (p<0.0001) in the AG, 79.7% sensitivity and 73.8% specificity (p<0.0001) in the cAG, and 79.3% sensitivity (p<0.0001) in the pSOFA+AG. In conclusion, pSOFA was more sensitive than PELOD-2, while the use of pSOFA+AG was not more sensitive than PELOD-2 in assessing the mortality of pediatric septic patients.

Keywords

Sepsis pediatric Sequential Organ Failure Assessment (pSOFA) anion gap (AG) Pediatric Logistic Organ Dysfunction-2 (PELOD-2) pediatric patient mortality child mortality

Article Details

License

Copyright (c) 2022 Folia Medica Indonesiana

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Siampa, J. P., Arie Utariani, & Elizeus Hanindito. (2022). Mortality Assessment of Pediatric Septic Patients Through Pediatric Sofa+Anion Gap and Pelod-2 Scores. Folia Medica Indonesiana, 58(4), 298–304. https://doi.org/10.20473/fmi.v58i4.14726
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Adams BD (2006). The anion gap does not accurately screen for lactic acidosis in emergency department patients. Emerg Med J 23, 179–82.
  2. Angus DC (2016). Opening the debate on the new sepsis definition defining sepsis: a case of bounded rationality and fuzzy thinking? Am J Respir Crit Care Med 194, 14–5.
  3. Berkman M, Ufberg J, Nathanson LA, et al (2009). Anion gap as a screening tool for elevated lactate in patients with an increased risk of developing sepsis in the Emergency Department. J Emerg Med 36, 391–4.
  4. Carcillo JA, Fields AI (2002). Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock. Crit Care Med 30, 1365–78.
  5. Costa RT, de Araújo OR, Caruso P (2018). Organ dysfunction and children sepsis: building a concept. J Emerg Crit Care Med 2, 51–51.
  6. Gogia P, Prasad S (2016). Utility of sequential organ failure assessment score in prognosticating sick children in pediatric intensive care unit. Int J Contemp Pediatr1193–6.
  7. Goldstein B, Giroir B, Randolph A (2005). International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 6, 2–8.
  8. Hartman ME, Linde-Zwirble WT, Angus DC, et al (2013). Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med 14, 686–93.
  9. Handayani, N., Lardo, S., & Nugrohowati, N. (2022). Difference of Procalcitonin Levels in Gram-Positive and Gram-Negative Bacterial Sepsis Patients of Indonesian Army Central Hospital Gatot Soebroto in 2016. JUXTA J Ilm Mhs Kedokt Univ Airlangga 13,38.
  10. Hunt A (2019). Sepsis: An overview of the signs, symptoms, diagnosis, treatment and pathophysiology. Emerg Nurse 27, 32–41.
  11. Kaukonen K-M, Bailey M, Pilcher D, et al (2015). Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med 372, 1629–38.
  12. Kawasaki T (2017). Update on pediatric sepsis: A review. J Intensive Care 5, 47.
  13. Kim MJ, Kim YH, Sol IS, et al (2017). Serum anion gap at admission as a predictor of mortality in the pediatric intensive care unit. Sci Rep 7, 1456.
  14. Levy MM, Evans LE, Rhodes A (2018). The Surviving Sepsis Campaign bundle: 2018 update. Intensive Care Med 44, 925–8.
  15. Matics TJ, Sanchez-Pinto LN (2017). Adaptation and validation of a pediatric sequential organ failure assessment score and evaluation of the sepsis-3 definitions in critically ill children. JAMA Pediatr 171, e172352.
  16. Park M, Taniguchi L, Noritomi D, et al (2008). Clinical utility of standard base excess in the diagnosis and interpretation of metabolic acidosis in critically ill patients. Brazilian J Med Biol Res 41, 241–9.
  17. Pasaribu FM, Setyaningtyas A, Andarsini MR (2021). Neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume as a predictor of sepsis mortality in children at Dr.Soetomo General Hospital. Crit Care Shock 24, 65–71.
  18. Pongmanee W, Vattanavanit V (2017). Can base excess and anion gap predict lactate level in diagnosis of septic shock? Open Access Emerg Med 10, 1–7.
  19. Priyatiningsih DR, Latief A, Pudjiadi AH (2016). Characteristics of sepsis in the pediatric intensive care unit of dr. Cipto Mangunkusumo hospital (Karakteristik sepsis di pediatric intensive care unit RS dr. Cipto Mangunkusumo) (thesis). Universitas Indonesia.
  20. Raith EP, Udy AA, Bailey M, et al (2017). Prognostic accuracy of the SOFA score, SIRS criteria, and qSOFA score for in-hospital mortality among adults with suspected infection admitted to the intensive care unit. JAMA 317, 290.
  21. Randolph AG, McCulloh RJ (2014). Pediatric sepsis. Virulence 5, 179–89.
  22. Rhodes A, Evans LE, Alhazzani W, et al (2017). Surviving Sepsis Campaign: International guidelines for the management of sepsis and septic shock: 2016. Crit Care Med 45, 486–552.
  23. Rijal S. Romdhoni AC (2018). Bacteria pattern, results of antibiotic sensitivity test, and complications of deep neck abscess patients in Dr. Soetomo General Hospital. Biomol Heal Sci J 1,124
  24. Schlapbach LJ (2017). Time for Sepsis-3 in children? Pediatr Crit Care Med 18, 805–6.
  25. Schlapbach LJ, Kissoon N (2018). Defining pediatric sepsis. JAMA Pediatr 172, 313.
  26. Schlapbach LJ, Straney L, Alexander J, et al (2015). Mortality related to invasive infections, sepsis, and septic shock in critically ill children in Australia and New Zealand, 2002–13: A multicentre retrospective cohort study. Lancet Infect Dis 15, 46–54.
  27. Schlapbach LJ, Straney L, Bellomo R, et al (2018). Prognostic accuracy of age-adapted SOFA, SIRS, PELOD-2, and qSOFA for in-hospital mortality among children with suspected infection admitted to the intensive care unit. Intensive Care Med 44, 179–88.
  28. Schlapbach LJ, Straney L, Gelbart B, et al (2017). Burden of disease and change in practice in critically ill infants with bronchiolitis. Eur Respir J 49, 1601648.
  29. Sneha K, Mhaske VR, Saha KK, et al (2022). Correlation of the changing trends of ScvO2, serum lactate, standard base excess and anion gap in patients with severe sepsis and septic shock managed by Early Goal Directed Therapy (EGDT): A prospective observational study. Anesth Essays Res 16, 272–7.
  30. Utomo, Sumitro R, tika R, et al (2021). Current- proven neonatal sepsis in ndonesian tertiary neonatal intensive care unit A hematoloical and microbioloical profile. ran J icrobiol., 2-2
  31. Weiss SL, Fitzgerald JC, Pappachan J, et al (2015). Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med 191, 1147–57.
  32. Wong HR (2022). Pediatric sepsis biomarkers for prognostic and predictive enrichment. Pediatr Res 91, 283–8.
  33. You JS, Park YS, Chung SP, et al (2022). Relationship between time of emergency department admission and adherence to the Surviving Sepsis Campaign bundle in patients with septic shock. Crit Care 26, 43.