Aims & Objectives

The pediatric sepsis research community has developed various prediction models in different settings and populations. The data sets generated, when shared between collaborators, have enormous potential to enable external validation and derivation of novel models. A limitation to data sharing is the lack of compatibility between data sets. We generated guidelines to facilitate a standardized approach to data collection for future predictive studies.

Methods

A preliminary list of relevant predictor variables was compiled through a systematic literature review and examination of global guideline documents. A modified Delphi process involving experts from the Pediatric Sepsis CoLab, in both resource-rich and resource-limited settings, was used to prioritize and standardize the list of predictors. Predictors were evaluated on considerations of existing guidelines, availability, cost, practicality, and clinical experience in low-resource settings.

Results

A study design guideline for selection and collection of pediatric sepsis predictors was generated. Each predictor variable was assigned either tier 1 (essential), tier 2 (important), or tier 3 (exploratory). Standardized prompts and accepted values were assigned to each predictor, using source studies when available. Branching logic was added to the predictors list to facilitate the design of efficient data collection tools. Guidelines and supplemental materials are hosted on the University of British Columbia Dataverse.

Conclusions

The guidelines are designed for applicability to a wide variety of settings and facility levels. This is not an attempt to restrict investigators to a set of predictors, but rather serves to enhance compatibility of future data sets in the interest of enabling continuous quality improvement of care.

Aims & Objectives

To evaluate the efficiency of the newly published pSOFA score to predict the risk of death in critically ill children with sepsis.

Methods

Eight PICU were enrolled from Jiangsu, Zhejiang and Shanghai between August 2016 and July 2017. The data were collected included age, gender, the length of PICU stay, and pSOFA score for all subjects. Death in hospital was the mainly clinical outcome. The performance of the pSOFA was assessed by the area under the ROC curve. The calibration for predicting mortality was evaluated by the Hosmer-Lemeshow goodness of fit test.

Results

A total of 651 cases of sepsis were enrolled in the PICU. 134 cases of discharge were not included in the analysis. A total of 517 cases were included in the study. There were 76 deaths in the hospital with sepsis, and the mortality rate was 11.7%. The median age was 43 months. The male-to-female ratio was 1.5:1. The area under the ROC curve for pSOFA was 0.844 (95% confidence interval 0.811-0.891). The Hosmer-Lemeshow goodness of fit test showed a good calibration(χ 2= 5.910, P=0.749) and was well fitted to the actual case mortality rate.

Conclusions

The pSOFA score had a good performance on predicting the sepsis mortality in PICU of the Yangtze River Delta in China, and it can be applied to predict the prognosis in critically ill children with sepsis.

Aims & Objectives

To find out the incidence of Hyperferritinemia in Severe Sepsis , Septic shock and its association with mortality

Methods

Prospective observational study from July 2018 to June 2019 at Rainbow Children's Hospital , Banjara hills , level IV PICU

Children > 1 month and less than 18 yeras admitted or those who developed Severe sepsis / septic shock during the hospital stay were included

Serum ferritin was measured within 24 hours of identification of sepsis and septic shock and subsequetly at 48 hrs, 72 hrs and 96 hrs .

Results

Out of 186 children who had severe sepsis and septic shock during the study peroid , 125 children were included in the study .

Median Intial ferritin was 5100 ng/ml ( 12- 1,61,200)

28 day mortality was 20% , 21% and 30 % in children with intial Ferritin < 500 ng/ml, 500-10,000 and > 10,000 ng/ml respectively

ROC curve of initial Ferritin levels vs mortality had AUC of 0.55 and an initial ferritin value of 4360 ng/ml had a 62.6 % sensitivity and 41.7 % specificty to predict mortality

Among children with more than two organ dysfunction ,ROC of initial ferritin vs mortality had AUC of 0.62 and an initial ferritin of 5110 ng/ml had a 57.7 % senstivity , 58.5 % specificty to predict mortality

Conclusions

Serum Ferritin levels can be helpful predictive marker of mortality in severe sepsis and septic shock and higher ferritin is associated with increasing organ dysfunction