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《Chongqing Medicine》 2012-07
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Derivation and evaluation of prognostic equation to predict in-hospital mortality of 128 children with severe sepsis

Xiang Guoyan,Wang Yuzhong(Department of Pediatrics,Luohe Medical College,Luohe,He′nan 462002,China)  
Objective To derive a prognostic equation to predict mortality of children with severe sepsis,and provide scientific guidance for prognostic assessment and treatment scheme formulation.Methods 128 children with severe sepsis admitted to pediatric intensive care unit(PICU) were included perspectively,and their gender,age,vital signs,loboratory indicators and pediatric critical illness score(PICS) were collected.They were divided into death group(56 cases) and survival group(72 cases) according to their in-hospital survival condition.Cox proportional-hazards regression was employed to derive the prognostic equation to predict mortality and the receiver operator characteristic(ROC) curve was used to evaluate its diagnostic performance.Results Diffe-rences of indicators included such as age,serum albumin,platelet count,white blood cell count,pathogens,duration of mechanical ventilation,pediatric critical illness score(PCIS),septic shock and multiple organ dysfunction syndrome(MODS) demonstrated statistical significance when univariate analysis was conducted in death group and survival group.Covariates selected for multivariate Cox regression equation were age(HR=0.281,95%CI:0.122~0.643),PCIS(HR=0.222,95%CI:0.099~0.499) and MODS(HR=3.110,95%CI:1.408~6.869).Prognostic equation to predict mortality was:h(t|X)/h0(t)=Exp(-1.271 age-1.506PCIS+1.135MODS).The areas under the ROC curve of prediction in-hospital mortality of children with severe sepsis according to equation and three factors of equation in descending order were equation,PCIS,MODS and age.Conclusion Prognostic equation to predict mortality based upon comprehensive indexes including age,PCIS and MODS has a certain reference value for evaluation of prognosis of children with severe sepsis.
【CateGory Index】: R720.597
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