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Abstract：
To evaluate the proportion of children fulfilling \"Sepsis-3\" definition and International Pediatric Sepsis Consensus Conference definition among children diagnosed to have septic shock and compare the mortality risk between the two groups.
Retrospective chart review.
PICU of a tertiary care teaching hospital from 2014 to 2017.
Children (≤ 17 yr old) with a diagnosis of septic shock at admission or during PICU stay.
None.
We applied both International Pediatric Sepsis Consensus Conference and the new \"Sepsis-3\" definition (sepsis with hypotension requiring vasopressors and a lactate value of ≥ 2 mmol/L) to identify cases of septic shock by these definitions. Key outcomes such as mortality, proportion attaining shock reversal at 24 hours and organ dysfunction were compared between those fulfilling \"Sepsis-3\" definitions (\"Sepsis-3\" group) and those fulfilling \"International Pediatric Sepsis Consensus Conference\" definition (\"International Pediatric Sepsis Consensus Conference\" group). A total of 216 patients fulfilled International Pediatric Sepsis Consensus Conference definitions of septic shock. Of these, only 104 (48%; 95% CI, 42-55) fulfilled \"Sepsis-3\" definition. Children fulfilling \"Sepsis-3 plus International Pediatric Sepsis Consensus Conference definitions\" (\"Sepsis-3 and International Pediatric Sepsis Consensus Conference\" group) had lower proportion with shock resolution (61% vs 82%; relative risk, 0.73; 95% CI, 0.62-0.88) and higher risk of multiple organ dysfunction (85% vs 68%; 1.24; 1.07-1.45) at 24 hours. The mortality was 48.5% in \"Sepsis-3 and International Pediatric Sepsis Consensus Conference\" group as compared with 37.5% in the \"International Pediatric Sepsis Consensus Conference only\" group (relative risk, 1.3; 95% CI, 0.94-1.75).
Less than half of children with septic shock identified by International Pediatric Sepsis Consensus Conference definitions were observed to fulfill the criteria for shock as per \"Sepsis-3\" definitions. Lack of difference in the risk of mortality between children who fulfilled \"Sepsis-3\" definition and those who did not fulfill the definition raises questions on the appropriateness of using this definition for diagnosis of septic shock in children.
Retrospective chart review.
PICU of a tertiary care teaching hospital from 2014 to 2017.
Children (≤ 17 yr old) with a diagnosis of septic shock at admission or during PICU stay.
None.
We applied both International Pediatric Sepsis Consensus Conference and the new \"Sepsis-3\" definition (sepsis with hypotension requiring vasopressors and a lactate value of ≥ 2 mmol/L) to identify cases of septic shock by these definitions. Key outcomes such as mortality, proportion attaining shock reversal at 24 hours and organ dysfunction were compared between those fulfilling \"Sepsis-3\" definitions (\"Sepsis-3\" group) and those fulfilling \"International Pediatric Sepsis Consensus Conference\" definition (\"International Pediatric Sepsis Consensus Conference\" group). A total of 216 patients fulfilled International Pediatric Sepsis Consensus Conference definitions of septic shock. Of these, only 104 (48%; 95% CI, 42-55) fulfilled \"Sepsis-3\" definition. Children fulfilling \"Sepsis-3 plus International Pediatric Sepsis Consensus Conference definitions\" (\"Sepsis-3 and International Pediatric Sepsis Consensus Conference\" group) had lower proportion with shock resolution (61% vs 82%; relative risk, 0.73; 95% CI, 0.62-0.88) and higher risk of multiple organ dysfunction (85% vs 68%; 1.24; 1.07-1.45) at 24 hours. The mortality was 48.5% in \"Sepsis-3 and International Pediatric Sepsis Consensus Conference\" group as compared with 37.5% in the \"International Pediatric Sepsis Consensus Conference only\" group (relative risk, 1.3; 95% CI, 0.94-1.75).
Less than half of children with septic shock identified by International Pediatric Sepsis Consensus Conference definitions were observed to fulfill the criteria for shock as per \"Sepsis-3\" definitions. Lack of difference in the risk of mortality between children who fulfilled \"Sepsis-3\" definition and those who did not fulfill the definition raises questions on the appropriateness of using this definition for diagnosis of septic shock in children.
摘要：
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