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Improved survival of children with sepsis and purpura: effects of age, gender, and era

BACKGROUND: To gain insight into factors that might affect results of future case-control studies, we performed an analysis of children with sepsis and purpura admitted to the paediatric intensive care unit (PICU) of Erasmus MC-Sophia Children's Hospital (Rotterdam, The Netherlands). METHODS: B...

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Autores principales: Maat, Martine, Buysse, Corinne MP, Emonts, Marieke, Spanjaard, Lodewijk, Joosten, Koen FM, de Groot, Ronald, Hazelzet, Jan A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556765/
https://www.ncbi.nlm.nih.gov/pubmed/17945008
http://dx.doi.org/10.1186/cc6161
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author Maat, Martine
Buysse, Corinne MP
Emonts, Marieke
Spanjaard, Lodewijk
Joosten, Koen FM
de Groot, Ronald
Hazelzet, Jan A
author_facet Maat, Martine
Buysse, Corinne MP
Emonts, Marieke
Spanjaard, Lodewijk
Joosten, Koen FM
de Groot, Ronald
Hazelzet, Jan A
author_sort Maat, Martine
collection PubMed
description BACKGROUND: To gain insight into factors that might affect results of future case-control studies, we performed an analysis of children with sepsis and purpura admitted to the paediatric intensive care unit (PICU) of Erasmus MC-Sophia Children's Hospital (Rotterdam, The Netherlands). METHODS: Between 1988 and 2006, all 287 children consecutively admitted with sepsis and purpura were included in various sepsis studies. Data regarding age, gender, ethnicity, serogroup of Neisseria meningitidis, severity, therapy, and survival were collected prospectively. These data were pooled into one database and analyzed retrospectively. RESULTS: The case fatality rate (CFR) from sepsis and purpura was 15.7%. During the study period, survival improved significantly. Younger age was significantly associated with more severe disease and a higher CFR. Children under the median age of 3.0 years had an increased risk of case fatality (odds ratio 4.3, 95% confidence interval 2.1 to 9.2; p < 0.001). Gender was not associated with CFR. However, males did have higher Paediatric Risk of Mortality scores, fewer PICU-free days, and more presence of shock. The course of sepsis and purpura was not related to ethnic origin. A causative organism was isolated in 84.3% of cases. N. meningitidis was the major organism (97.5%). Although N. meningitidis serogroup B was observed more often in younger children, serogroups were not associated with severity or survival. During the study period, the use of inotropic agents and corticosteroids changed substantially (less dopamine and more dobutamine, norepinephrine, and corticosteroids). CONCLUSION: Age and gender are determinants of severity of paediatric sepsis and purpura. Survival rates have improved during the last two decades.
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spelling pubmed-25567652008-10-01 Improved survival of children with sepsis and purpura: effects of age, gender, and era Maat, Martine Buysse, Corinne MP Emonts, Marieke Spanjaard, Lodewijk Joosten, Koen FM de Groot, Ronald Hazelzet, Jan A Crit Care Research BACKGROUND: To gain insight into factors that might affect results of future case-control studies, we performed an analysis of children with sepsis and purpura admitted to the paediatric intensive care unit (PICU) of Erasmus MC-Sophia Children's Hospital (Rotterdam, The Netherlands). METHODS: Between 1988 and 2006, all 287 children consecutively admitted with sepsis and purpura were included in various sepsis studies. Data regarding age, gender, ethnicity, serogroup of Neisseria meningitidis, severity, therapy, and survival were collected prospectively. These data were pooled into one database and analyzed retrospectively. RESULTS: The case fatality rate (CFR) from sepsis and purpura was 15.7%. During the study period, survival improved significantly. Younger age was significantly associated with more severe disease and a higher CFR. Children under the median age of 3.0 years had an increased risk of case fatality (odds ratio 4.3, 95% confidence interval 2.1 to 9.2; p < 0.001). Gender was not associated with CFR. However, males did have higher Paediatric Risk of Mortality scores, fewer PICU-free days, and more presence of shock. The course of sepsis and purpura was not related to ethnic origin. A causative organism was isolated in 84.3% of cases. N. meningitidis was the major organism (97.5%). Although N. meningitidis serogroup B was observed more often in younger children, serogroups were not associated with severity or survival. During the study period, the use of inotropic agents and corticosteroids changed substantially (less dopamine and more dobutamine, norepinephrine, and corticosteroids). CONCLUSION: Age and gender are determinants of severity of paediatric sepsis and purpura. Survival rates have improved during the last two decades. BioMed Central 2007 2007-10-18 /pmc/articles/PMC2556765/ /pubmed/17945008 http://dx.doi.org/10.1186/cc6161 Text en Copyright © 2007 Maat et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Maat, Martine
Buysse, Corinne MP
Emonts, Marieke
Spanjaard, Lodewijk
Joosten, Koen FM
de Groot, Ronald
Hazelzet, Jan A
Improved survival of children with sepsis and purpura: effects of age, gender, and era
title Improved survival of children with sepsis and purpura: effects of age, gender, and era
title_full Improved survival of children with sepsis and purpura: effects of age, gender, and era
title_fullStr Improved survival of children with sepsis and purpura: effects of age, gender, and era
title_full_unstemmed Improved survival of children with sepsis and purpura: effects of age, gender, and era
title_short Improved survival of children with sepsis and purpura: effects of age, gender, and era
title_sort improved survival of children with sepsis and purpura: effects of age, gender, and era
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556765/
https://www.ncbi.nlm.nih.gov/pubmed/17945008
http://dx.doi.org/10.1186/cc6161
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