玻利维亚危重儿童的脓毒症:2023年队列中Phoenix脓毒症标准的多中心回顾性评价

IF 4 2区 医学 Q1 CRITICAL CARE MEDICINE
Raul Copana-Olmos, Nils Casson-Rodriguez, Willmer Diaz-Villalobos, Victor Urquieta-Clavel, Mary Tejerina-Ortiz, Carol Mendoza-Montoya, Maricruz Fernandez-Vidal, Mariel Forest-Yepez, Danny Blanco-Espejo, Ibeth Rivera-Murguia, Claudia Castro-Auza, Milenka Gamboa-Lanza, Jhovana E Paco-Barral, Gustavo Choque-Osco, Betzhi Vera-Dorado, Magbely Cuellar-Gutierrez, Alan J Sarmiento-Zurita, Michelle G Carrillo-Vargas, Brisa W Ledezma-Hurtado, L Nelson Sanchez-Pinto
{"title":"玻利维亚危重儿童的脓毒症:2023年队列中Phoenix脓毒症标准的多中心回顾性评价","authors":"Raul Copana-Olmos, Nils Casson-Rodriguez, Willmer Diaz-Villalobos, Victor Urquieta-Clavel, Mary Tejerina-Ortiz, Carol Mendoza-Montoya, Maricruz Fernandez-Vidal, Mariel Forest-Yepez, Danny Blanco-Espejo, Ibeth Rivera-Murguia, Claudia Castro-Auza, Milenka Gamboa-Lanza, Jhovana E Paco-Barral, Gustavo Choque-Osco, Betzhi Vera-Dorado, Magbely Cuellar-Gutierrez, Alan J Sarmiento-Zurita, Michelle G Carrillo-Vargas, Brisa W Ledezma-Hurtado, L Nelson Sanchez-Pinto","doi":"10.1097/PCC.0000000000003714","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the Phoenix criteria and the Phoenix Sepsis Score in a multicenter retrospective cohort of critically ill children with a clinical diagnosis of sepsis or septic shock in Bolivia. In addition, we aimed to assess whether management in a PICU at high altitude in the Bolivian Andes was associated with the performance of the respiratory dysfunction component in the Phoenix Sepsis Score.</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Setting: </strong>Fourteen PICUs in Bolivia.</p><p><strong>Patients: </strong>Children admitted to the PICU with a clinical diagnosis of sepsis or septic shock from January 2023 to December 2023.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>There were 273 patients with a diagnosis of sepsis in 2023, of which 257 (94.1%) met the 2024 Phoenix criteria for sepsis, and 166 (60.8%) met the systemic inflammatory response syndrome (SIRS)-based criteria for sepsis. Among the 257 patients meeting Phoenix sepsis criteria, 86 died (33.5%). Of the patients with Phoenix-based sepsis, there were 100 of 257 (38.9%) who were SIRS-negative, and 27 of 100 died (27.0%). After correcting the oxygenation indices for altitude, 149 of 273 patients (54.6%) had a lower Phoenix respiratory score and an associated mortality more consistent with the expected mortality of the newly derived subscore. Patients at higher altitudes had higher hemoglobin levels and higher estimated oxygen carrying capacity, and these data were independently associated with lower odds of mortality after controlling for altitude-corrected Phoenix score.</p><p><strong>Conclusions: </strong>In this 2023, retrospective cohort of PICU patients with sepsis in Bolivia, we have found that the majority met the 2024 Phoenix sepsis criteria, but less than two-thirds met the SIRS-based criteria for diagnosis. However, the respiratory score in the Phoenix criteria overestimated the severity of respiratory dysfunction in more than half of the cohort, likely because the score does not take account of the Andean adaptation to high altitude, with higher oxygen carrying capacity.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sepsis in Critically Ill Children in Bolivia: Multicenter Retrospective Evaluation of the Phoenix Criteria for Sepsis in a 2023 Cohort.\",\"authors\":\"Raul Copana-Olmos, Nils Casson-Rodriguez, Willmer Diaz-Villalobos, Victor Urquieta-Clavel, Mary Tejerina-Ortiz, Carol Mendoza-Montoya, Maricruz Fernandez-Vidal, Mariel Forest-Yepez, Danny Blanco-Espejo, Ibeth Rivera-Murguia, Claudia Castro-Auza, Milenka Gamboa-Lanza, Jhovana E Paco-Barral, Gustavo Choque-Osco, Betzhi Vera-Dorado, Magbely Cuellar-Gutierrez, Alan J Sarmiento-Zurita, Michelle G Carrillo-Vargas, Brisa W Ledezma-Hurtado, L Nelson Sanchez-Pinto\",\"doi\":\"10.1097/PCC.0000000000003714\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>We evaluated the Phoenix criteria and the Phoenix Sepsis Score in a multicenter retrospective cohort of critically ill children with a clinical diagnosis of sepsis or septic shock in Bolivia. In addition, we aimed to assess whether management in a PICU at high altitude in the Bolivian Andes was associated with the performance of the respiratory dysfunction component in the Phoenix Sepsis Score.</p><p><strong>Design: </strong>Multicenter retrospective cohort study.</p><p><strong>Setting: </strong>Fourteen PICUs in Bolivia.</p><p><strong>Patients: </strong>Children admitted to the PICU with a clinical diagnosis of sepsis or septic shock from January 2023 to December 2023.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>There were 273 patients with a diagnosis of sepsis in 2023, of which 257 (94.1%) met the 2024 Phoenix criteria for sepsis, and 166 (60.8%) met the systemic inflammatory response syndrome (SIRS)-based criteria for sepsis. Among the 257 patients meeting Phoenix sepsis criteria, 86 died (33.5%). Of the patients with Phoenix-based sepsis, there were 100 of 257 (38.9%) who were SIRS-negative, and 27 of 100 died (27.0%). After correcting the oxygenation indices for altitude, 149 of 273 patients (54.6%) had a lower Phoenix respiratory score and an associated mortality more consistent with the expected mortality of the newly derived subscore. Patients at higher altitudes had higher hemoglobin levels and higher estimated oxygen carrying capacity, and these data were independently associated with lower odds of mortality after controlling for altitude-corrected Phoenix score.</p><p><strong>Conclusions: </strong>In this 2023, retrospective cohort of PICU patients with sepsis in Bolivia, we have found that the majority met the 2024 Phoenix sepsis criteria, but less than two-thirds met the SIRS-based criteria for diagnosis. However, the respiratory score in the Phoenix criteria overestimated the severity of respiratory dysfunction in more than half of the cohort, likely because the score does not take account of the Andean adaptation to high altitude, with higher oxygen carrying capacity.</p>\",\"PeriodicalId\":19760,\"journal\":{\"name\":\"Pediatric Critical Care Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-02-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Critical Care Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PCC.0000000000003714\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Critical Care Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PCC.0000000000003714","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 0

摘要

目的:我们对玻利维亚临床诊断为败血症或感染性休克的危重儿童进行多中心回顾性队列评估Phoenix标准和Phoenix败血症评分。此外,我们的目的是评估玻利维亚安第斯山脉高海拔地区PICU的管理是否与Phoenix败血症评分中呼吸功能障碍成分的表现有关。设计:多中心回顾性队列研究。背景:玻利维亚的14个picu。患者:2023年1月至2023年12月,临床诊断为败血症或感染性休克的儿童入住PICU。干预措施:没有。测量及主要结果:2023年诊断为脓毒症的患者273例,其中257例(94.1%)符合2024年Phoenix脓毒症标准,166例(60.8%)符合基于全身炎症反应综合征(SIRS)的脓毒症标准。257例符合Phoenix脓毒症标准的患者中,86例死亡(33.5%)。在phoenix型脓毒症患者中,257例中有100例(38.9%)为sirs阴性,100例中有27例死亡(27.0%)。校正海拔氧合指数后,273例患者中有149例(54.6%)凤凰呼吸评分较低,相关死亡率与新导出亚评分的预期死亡率更一致。海拔较高的患者血红蛋白水平较高,估计携氧能力较高,在控制了海拔校正凤凰评分后,这些数据与较低的死亡率独立相关。结论:在2013年玻利维亚PICU脓毒症患者的回顾性队列中,我们发现大多数患者符合2024年Phoenix脓毒症标准,但不到三分之二的患者符合基于sirs的诊断标准。然而,Phoenix标准中的呼吸评分高估了超过一半的队列呼吸功能障碍的严重程度,可能是因为该评分没有考虑到安第斯山脉对高海拔的适应,具有更高的载氧能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sepsis in Critically Ill Children in Bolivia: Multicenter Retrospective Evaluation of the Phoenix Criteria for Sepsis in a 2023 Cohort.

Objectives: We evaluated the Phoenix criteria and the Phoenix Sepsis Score in a multicenter retrospective cohort of critically ill children with a clinical diagnosis of sepsis or septic shock in Bolivia. In addition, we aimed to assess whether management in a PICU at high altitude in the Bolivian Andes was associated with the performance of the respiratory dysfunction component in the Phoenix Sepsis Score.

Design: Multicenter retrospective cohort study.

Setting: Fourteen PICUs in Bolivia.

Patients: Children admitted to the PICU with a clinical diagnosis of sepsis or septic shock from January 2023 to December 2023.

Interventions: None.

Measurements and main results: There were 273 patients with a diagnosis of sepsis in 2023, of which 257 (94.1%) met the 2024 Phoenix criteria for sepsis, and 166 (60.8%) met the systemic inflammatory response syndrome (SIRS)-based criteria for sepsis. Among the 257 patients meeting Phoenix sepsis criteria, 86 died (33.5%). Of the patients with Phoenix-based sepsis, there were 100 of 257 (38.9%) who were SIRS-negative, and 27 of 100 died (27.0%). After correcting the oxygenation indices for altitude, 149 of 273 patients (54.6%) had a lower Phoenix respiratory score and an associated mortality more consistent with the expected mortality of the newly derived subscore. Patients at higher altitudes had higher hemoglobin levels and higher estimated oxygen carrying capacity, and these data were independently associated with lower odds of mortality after controlling for altitude-corrected Phoenix score.

Conclusions: In this 2023, retrospective cohort of PICU patients with sepsis in Bolivia, we have found that the majority met the 2024 Phoenix sepsis criteria, but less than two-thirds met the SIRS-based criteria for diagnosis. However, the respiratory score in the Phoenix criteria overestimated the severity of respiratory dysfunction in more than half of the cohort, likely because the score does not take account of the Andean adaptation to high altitude, with higher oxygen carrying capacity.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Pediatric Critical Care Medicine
Pediatric Critical Care Medicine 医学-危重病医学
CiteScore
7.40
自引率
14.60%
发文量
991
审稿时长
3-8 weeks
期刊介绍: Pediatric Critical Care Medicine is written for the entire critical care team: pediatricians, neonatologists, respiratory therapists, nurses, and others who deal with pediatric patients who are critically ill or injured. International in scope, with editorial board members and contributors from around the world, the Journal includes a full range of scientific content, including clinical articles, scientific investigations, solicited reviews, and abstracts from pediatric critical care meetings. Additionally, the Journal includes abstracts of selected articles published in Chinese, French, Italian, Japanese, Portuguese, and Spanish translations - making news of advances in the field available to pediatric and neonatal intensive care practitioners worldwide.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信