Prognostic factors of 28-day mortality in pediatric septic shock: A prospective cohort study

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Prognostic factors of 28-day mortality in pediatric septic shock: A prospective cohort study

Authors

  • Phuong Minh Nguyen Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0000-0002-3857-9420
  • Ly Cong Tran Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0000-0003-0090-7289
  • Duy-Truong Khac Le Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam https://orcid.org/0009-0001-8908-0021
  • Viet Trieu Nguyen Department of Otolaryngology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam

Keywords:

Septic shock, Mortality, Prognostic factors, Pediatrics, Critical care

Abstract

Background and aim: Septic shock is a leading cause of mortality in children, particularly in Vietnam. Limited intensive care resources in low- and middle-income countries make it crucial to identify predictors of 28-day mortality to optimize patient outcomes. This study aimed to identify factors associated with 28-day mortality in pediatric patients with septic shock. Methods: A prospective cohort study was conducted on pediatric patients aged 2 months to 15 years who were diagnosed with septic shock in the Pediatric Intensive Care Unit of a tertiary pediatric hospital in southern Vietnam between July 2022 and June 2024. Results: Clinical and laboratory manifestations of septic shock at diagnosis varied widely among patients. The cumulative 28-day mortality rate was 64.1% (95% CI: 45.7–76.2%), with most fatal outcomes (53.8%; 95% CI: 35.6–66.8%) occurring within the first week. Although infants and male patients had the highest incidence rates of septic shock, these demographic factors were not significantly associated with mortality. Neurological, renal, and hematological dysfunctions, along with a lactate-to-albumin ratio (LAR) ≥ 1.84, were identified as independent predictors of 28-day mortality. A LAR ≥ 1.84 was associated with a 7.14-fold increase in mortality risk (95% CI: 2.56–24.9, p < 0.001). Conclusions: Pediatric septic shock is associated with a high 28-day mortality rate and diverse clinical presentations. Neurological, renal, and hematological dysfunctions, as well as a lactate-to-albumin ratio ≥ 1.84, were identified as independent prognostic factors for mortality, underscoring the need for focused management of these risk factors.

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How to Cite

1.
Nguyen PM, Tran LC, Le DTK, Nguyen VT. Prognostic factors of 28-day mortality in pediatric septic shock: A prospective cohort study. Acta Biomed. 96(2):16572. doi:10.23750/abm.v96i2.16572

Issue

Section

PEDIATRICS AND ADOLESCENT MEDICINE

How to Cite

1.
Nguyen PM, Tran LC, Le DTK, Nguyen VT. Prognostic factors of 28-day mortality in pediatric septic shock: A prospective cohort study. Acta Biomed. 96(2):16572. doi:10.23750/abm.v96i2.16572