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CLINICAL AND LABORATORY CHARACTERISTICS, MORTALITY RATE, AND ASSOCIATED FACTORS IN PEDIATRIC SEPSIS AT CAN THO CHILDREN'S HOSPITAL, 2022-2024
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Abstract
ackground: Sepsis is a condition with non-specific clinical symptoms that vary among patients and depending on the primary source of infection. Consequently, its manifestations often become clear only in the late stages. Objective: To describe the clinical and laboratory characteristics and to determine the mortality rate and its associated factors in pediatric patients with sepsis at Can Tho Children's Hospital from 2022 to 2024. Subjects and Methods: A descriptive, analytical cross-sectional study was conducted on 99 pediatric patients, aged 1 month to 16 years, diagnosed with septic shock and admitted to the Department of Emergency, Intensive Care and Toxicology at Can Tho Children's Hospital between April 2021 and July 2022. Results: The study recorded that 63.6% of children had septic shock, a condition associated with factors such as age group, malnutrition, and chronic comorbidities. The primary sources of infection were predominantly the gastrointestinal and respiratory tracts, with gastrointestinal infections having the highest rate of progression to shock. Laboratory parameters associated with disease severity included procalcitonin, creatinine, AST, ALT, pH, and the PaO2/FiO2 ratio, whereas the positive blood culture rate was low (21.2%) and showed no significant association. Regarding outcomes, the overall mortality rate was exceptionally high at 54.5% (rising to 73% in the septic shock group). Multiple organ dysfunction syndrome (MODS), present in 79.8% of children, was the most potent predictor of mortality (increasing the risk of death 36.6-fold), alongside other independent factors including malnutrition, underlying diseases, pH, the PaO2/FiO2 ratio, and the change in Shock Index (∆SI). Conclusion: Sepsis in children is characterized by severe clinical presentations with a high rate of shock, leading to an alarming mortality rate. The primary factors associated with mortality are multiple organ dysfunction syndrome, malnutrition, underlying diseases, metabolic acidosis, and hypoxemia
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Keywords
sepsis, clinical, laboratory, mortality, Can Tho.
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