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dc.contributor.authorRech, Leandrapt_BR
dc.contributor.authorSousa, Ian Teixeira ept_BR
dc.contributor.authorTonial, Cristian Tedescopt_BR
dc.contributor.authorPiva, Jefferson Pedropt_BR
dc.date.accessioned2023-11-17T03:21:55Zpt_BR
dc.date.issued2022pt_BR
dc.identifier.issn0021-7557pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/267141pt_BR
dc.description.abstractObjective To investigate the role of Complex Chronic Conditions (CCCs) on the outcomes of pediatric patients with refractory septic shock, as well as the accuracy of PELOD-2 and Vasoactive Inotropic Score (VIS) to predict mortality in this specific population. Methods This is a single-center, retrospective cohort study. All patients diagnosed with septic shock requiring vasoactive drugs admitted to a 13-bed PICU in southern Brazil, between January 2016 and July 2018, were included. Clinical and demographic characteristics, presence of CCCs and VIS, and PELOD-2 scores were accessed by reviewing electronic medical records. The main outcome was considered PICU mortality. Results 218 patients with septic shock requiring vasoactive drugs were identified in the 30-month period and 72% of them had at least one CCC. Overall mortality was 22%. Comparing to patients without previous comorbidities, those with CCCs had a higher mortality (26.7% vs 9.8%; OR = 3.4 [1.3–8.4]) and longer hospital length of stay (29.3 vs 14.8; OR 2.39 [1.1- 5.3]). Among the subgroups of CCCs, “Malignancy” was particularly associated with mortality (OR = 2.3 [1.0–5.1]). VIS and PELOD-2 scores in 24 and 48 hours were associated with mortality and a PELOD-2 in 48 hours > 8 had the best performance in predicting mortality in patients with CCC (AUROC = 0.89). Conclusion Patients with CCCs accounted for the majority of those admitted to the PICU with septic shock and related to poor outcomes. The high prevalence of hospitalizations, use of resources, and significant mortality determine that patients with CCCs should be considered a priority in the healthcare system.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofJornal de pediatria. Rio de Janeiro. Vol. 98, no. 6 (2022), p. 614-620pt_BR
dc.rightsOpen Accessen
dc.subjectSepsept_BR
dc.subjectSepsisen
dc.subjectPediatric critical careen
dc.subjectCuidados críticospt_BR
dc.subjectUnidades de terapia intensiva pediátricapt_BR
dc.subjectComplex chronic conditionsen
dc.subjectCriançapt_BR
dc.subjectPediatriapt_BR
dc.subjectEpidemiologiapt_BR
dc.subjectChoque sépticopt_BR
dc.subjectDoença crônicapt_BR
dc.titleEpidemiology and outcomes of septic shock in children with complex chronic conditions in a developing country PICUpt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb001185868pt_BR
dc.type.originNacionalpt_BR


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