title: Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with diarrhoea.
abstract: OBJECTIVE
  To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not.
  
  
  METHODS
  We carried out a retrospective chart review on children aged 0-59 months admitted to the Dhaka Hospital, International Centre for Diarrhoeal Diseases Research, Bangladesh, with diarrhoea between October 2010 and September 2011. They were included if they had severe sepsis defined as tachycardia plus hyperthermia or hypothermia or an abnormal white blood cell count plus poor peripheral perfusion in absence of dehydration. Patients unresponsive to fluid and boluses, who required inotropes, were categorised as having septic shock (n = 88). The controls were those without septic shock (n = 116).
  
  
  RESULTS
  Death was significantly higher among the children with septic shock (67%) than the controls (14%) (p < 0.001). A logistic regression analysis, adjusted for potential confounders, found that children with septic shock were more likely to be drowsy on admission and received blood transfusions and mechanical ventilation (all p < 0.05).
  
  
  CONCLUSIONS
  Children hospitalised for diarrhoea with septic shock were more likely to die, be drowsy on admission and receive blood transfusions and mechanical ventilation. A randomised clinical trial on inotropes in children with diarrhoea, severe sepsis and drowsiness may expedite their use and prevent mechanical ventilation and deaths.
authors.affiliation: Clinical Service (CS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Monira
authors.initials: M
authors.lastname: Sarmin
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.forename: Pradip K
authors.initials: PK
authors.lastname: Bardhan
authors.forename: Mohammod J
authors.initials: MJ
authors.lastname: Chisti
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002675:Child, Preschool; D003967:Diarrhea / Q000150:complications* / Q000401:mortality*; D006801:Humans; D012189:Retrospective Studies; D012772:Shock, Septic / Q000209:etiology* / Q000401:mortality; D012894:Sleep Stages
keywords: Bangladesh; Children; Diarrhoea; Septic shock; Severe sepsis