Clinical Features And Risk Factors Associated With The Death Of Sever Sepsis In Children

Objective : Diagnosis and treatment of severe sepsis received extensive attention in the field of critical care medicine, it is a major cause of death in children in the PICU. By understanding the incidence of severe sepsis, clinical features, symptoms of infection, to analyze the prognostic factors, to help early diagnosis and treatment of severe sepsis, thereby improving the prognosis and reduce mortality.Methods:In accordance with international pediatric sepsis in 2005,co-session customized pediatric sepsis and severe sepsis diagnostic criteria diagnostic criteria for severe sepsis screening between January 2013 to December 2014 for two years, Chongqing Medical University children with severe sepsis children’s hospital PICU ward accommodation shall be applied case-control retrospective analysis and research methods, severe sepsis incidence, clinical features, epidemiology, treatment, a total of 19 factors. While the single factor analysis and Logistic regression analysis of the above factors, the independent risk factors for severe sepsis understand the prognosis of outcome-related.Results:(1)year in our hospital PICU ward of 4357 cases in children,the incidence of severe sepsis had 109 cases, the incidence was 2.5%(109/4357), 58 cases of children less than 1 year of age, accounting for53.21 percent, males accounted for 63.3%(69/109), women accounted for36.7%(40/109), primary foci for the respiratory tract are 33.03%(36/109),digestive(intestinal infection or peritonitis) 32.11%(35 / 109), intracranial infection 12.84%(14/109), while the respiratory system and the digestive system is the primary lesion 8.26%(9/109).(2)there is clear evidence of etiology of 59 cases of bacterial infections in children with evidence of etiology occupy 76.3%, G- common bacteria, 81.65% of children before hospital with fever, hospital fever before an average of 3.7 days, 102 there are cases of children with PCIS score statistics branch of the average score of 70.29,39 thrombocytopenia patients, 77 cases of children with hypoalbuminemia, 79 cases of children with elevated blood lactate performance.( 3) 109 cases of 83 patients with respiratory failure,mechanical ventilation, 31 cases(28.44%) the use of intravenous corticosteroids, admitted the use of antibiotics in 1 hour, 88 cases, 71 cases(65%) used carbon green mildew alkenes antibiotic, 35 cases((32.11%)used gamma globulin and 76 patients used vasoactive drugs.( 4) 109 patients, 30 patients died, the mortality rate was 27.52%, 72 cases(66 %),shock, mortality was 31.94%; children 82 cases(75.2%) of severe sepsis and MODS is accompanied by three below and three or more organdysfunction, respectively 60 cases and 22 cases,mortality was 26.67% and40.91%.(5)the prognosis of severe sepsis and PICS ratings, the use of gamma globulin, use of vasoactive drugs negatively correlated(P <0.05).Conclusion:The incidence of severe sepsis in the PICU higher, more common in infants and young children, especially infants under 1 year of age, high mortality. The main factors related to death primary foci for the respiratory and digestive tract, pathogenic bacteria common to G-, PCIS score using gamma globulin and the use of vasoactive drugs severe sepsis.