title: Prognostic factors in pediatric sepsis study, from the Spanish Society of Pediatric Intensive Care.
abstract: BACKGROUND
  Sepsis 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.
  
  
  METHODS
  Multicenter 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.
  
  
  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 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).
  
  
  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.
authors.affiliation: 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.
authors.forename: David
authors.initials: D
authors.lastname: Vila Pérez
authors.forename: Iolanda
authors.initials: I
authors.lastname: Jordan
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Esteban
authors.forename: Patricia
authors.initials: P
authors.lastname: García-Soler
authors.forename: Vega
authors.initials: V
authors.lastname: Murga
authors.forename: Vanesa
authors.initials: V
authors.lastname: Bonil
authors.forename: Irene
authors.initials: I
authors.lastname: Ortiz
authors.forename: Carlos
authors.initials: C
authors.lastname: Flores
authors.forename: Amaya
authors.initials: A
authors.lastname: Bustinza
authors.forename: Francisco Jose
authors.initials: FJ
authors.lastname: Cambra
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality*; D013030:Spain / Q000453:epidemiology