INITIAL PEDIATRIC SEQUENTIAL ORGAN FAILURE ASSESSMENT SUB-SCORES AS A MORTALITY PREDICTOR IN CHILDREN WITH SEPSIS AND MECHANICAL VENTILATION
Winda Paramitha,Desy Rusmawatiningtyas,Rina Triasih
Universitas Gadjah Mada
Background : Children with sepsis, in particular those who need mechanical ventilator, are at higher risk for mortality. Pediatric Sequential Organ Failure Assessment (pSOFA) has been shown to be useful in predicting mortality in children with sepsis. This study aimed to evaluate pSOFA sub-scores on admission as a predictor of mortality in children with sepsis and mechanically ventilated.
Material : We conducted a retrospective cohort study involving children with sepsis and mechanically ventilated who were admitted to PICU Sardjito Hospital between January 2015 and June 2017. We reviewed medical record to calculate pSOFA sub-scores (respiratory, coagulation, hepatic, cardiovascular, neurology and renal sub-scores) on the admission and to reveal the outcomes of the eligible children. We performed logistic regression and multivariate analysis.
Results : A total of 59 children were eligible for the study. Of them, 62.7% was male with median of age was 12 mo (IQR 7-50). Twenty seven (45.8%) children was died during admission. The Median for pSOFA score was 9 (IQR 8-11). From six sub-scores of pSOFA, only respiratory sub-scores showed significant prediction of mortality (OR 10.1, p 0.009, 95% CI 1.77-57.91) with highest mortality rate observed in group with PO2/FiO2 <100 (score 4).
Conclusions : pSOFA respiratory sub-scores >3 on admission could predict mortality in children with sepsis and mechanical ventilation.