Universität zu Köln

Breuling, T., Tschiedel, E., Grosse-Lordemann, A., Huenseler, C., Schmidt, C., Niemann, F., Dettmer, P., Freymann, H., von Noorden, C., Wallot, M., Heister, P., Heitmann, F., Rothoeft, T., Schuermann, U., Backendorf, A., Heldmann, M., Schubert, E., Nunez, F. B., Seiffert, P., Felderhoff-Mueser, U. and Dohna-Schwake, C. (2015). Septic Shock in Children in an Urban Area in Western Germany - Outcome, Risk Factors for Mortality and Infection Epidemiology. Klinische Padiatr., 227 (2). S. 61 - 66. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-3824

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Abstract

Background: Only sparse data exist about children with septic shock in Europe. The present study aimed to evaluate demographics, treatment, outcome and risk factors for mortality in Western Germany. Patients: Children with septic shock aged 2 months to 17 years. Methods: In a multi-center retrospective study of 20 children's hospitals data were obtained and analyzed by chart review. Risk factors for mortality were identified and assessed by multivariate regression analysis. Results: Overall mortality in 83 cases with septic shock was 25 % (21 patients). Significant risk factors were high PRISM III score, low pH, low arterial systolic blood pressure, presence of disseminated intravascular coagulation and extent of multi-organ failure, but not lactate (p = 0.05) and base excess (p = 0.065). Mortality in hospitals which treated 10 or more patients (category 1) was 17 % and increased to 22 % in hospitals which treated 3-6 patients (category 2). In hospitals with only 1 or 2 patients (category 3) mortality rate was 61 % (p < 0.01 when compared to category 1 or 2). A stepwise increase was also seen in the severely sick patients according to PRISM III (> 19): category 1: 23 %, category 2: 40 %, category 3: 62.5 % (p < 0.05 for comparison of category 1 and 3). Multivariate analysis of significant risk factors revealed low number of treated patients as the only individual risk factor for mortality. Conclusion: Mortality from pediatric septic shock in an urban area in Western Germany is high. Disease severity and treatment in a department with few cases were associated with increased mortality.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Breuling, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tschiedel, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Grosse-Lordemann, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Huenseler, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Niemann, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dettmer, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Freymann, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED von Noorden, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wallot, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heister, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heitmann, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rothoeft, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schuermann, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Backendorf, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heldmann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schubert, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nunez, F. B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seiffert, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Felderhoff-Mueser, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohna-Schwake, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-406151
DOI:	10.1055/s-0034-1398690
Journal or Publication Title:	Klinische Padiatr.
Volume:	227
Number:	2
Page Range:	S. 61 - 66
Date:	2015
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-3824
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SEVERE SEPSIS; HEMODYNAMIC SUPPORT; AMERICAN-COLLEGE; GUIDELINES; MANAGEMENT Multiple languages Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/40615