Apr 18, 2020

Risk of Mortality in Immunocompromised Children With Severe Sepsis and Septic Shock

Critical Care Medicine
Robert B LindellJulie C Fitzgerald

Abstract

To assess the prevalence of immunocompromised diagnoses among children with severe sepsis and septic shock, and to determine the association between immunocompromised diagnoses and clinical outcomes after adjustment for demographics and illness severity. Retrospective multicenter cohort study. Eighty-three centers in the Virtual Pediatric Systems database. Children with severe sepsis or septic shock admitted to a participating PICU between January 1, 2012, and December 31, 2016. None. Across 83 centers, we identified 10,768 PICU admissions with an International Classification of Diseases, 9th Revision, Clinical Modification code for severe sepsis or septic shock; 3,021 of these patients (28%) had an immunocompromised diagnosis. To evaluate variation across centers and determine factors associated with PICU mortality, we used mixed-effect logistic regression models. Among patients without hematopoietic cell transplant, congenital immunodeficiency (adjusted odds ratio, 1.90; 95% CI, 1.24-2.92), multiple prior malignancies (adjusted odds ratio, 1.86; 95% CI, 1.15-2.99), and hemophagocytic lymphohistiocytosis (adjusted odds ratio, 3.09; 95% CI, 1.91-4.98) were associated with an increased odds of PICU mortality. Among patients with...Continue Reading

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Mentioned in this Paper

Lymphohistiocytosis, Hemophagocytic
Malignant Neoplasms
Sepsis
Medical History
Hospital Admission
Pediatric Intensive Care Unit
Septic Shock
Immunocompromised Host
Logistic Regression
Health Center

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