The performance of early lactic acid measurement combined with Pediatric Critical Illness Score in evaluating the prognosis of children with sepsis in pediatric intensive care units / 中华实用儿科临床杂志

ABSTRACT

Objective@#To explore the performance of early lactic acid measurement combined with Pediatric Critical Illness Score (PCIS) in evaluating the prognosis of children with sepsis in the Pediatric Intensive Care Unit (PICU).@*Methods@#The data of 516 pediatric patients in PICU of the Affiliated Hospital of Guangdong Medical University from June 2016 to June 2018, diagnosed as sepsis were retrospectively analyzed.The patients were divided into survival group and non-survival group according to the clinical outcome of 28 days after admission.The variables of PCIS were collected and scored.Receiver operating characteristic curve (ROC curve) was drawn, and the efficiency of the early lactic acid measurement combined with PCIS for predicting death was evaluated by using the area under ROC curve (AUC).@*Results@#Of 516 pediatric patients with sepsis, 238 cases (46.1%) were common sepsis, 262 cases (50.8%) were severe sepsis, and 16 cases (3.1%) were septic shock.Among them, 488 cases (94.6%) were pe-diatric patients survived, while 28 cases (5.4%) did not survive during hospitalization.PCIS in non-survival group [86(82, 88) scores]was significantly lower than that of survival group [92(86, 96) scores]and the early lactic acid measurement was significantly increased[2.8(1.1, 10.3) mmol/L vs.1.2(0.8, 1.9) mmol/L](Z=3 259.5, 9 953.5, all P<0.05). ROC curve analysis showed that the AUCs of early lactic acid measurement, PCIS, early lactic acid measurement combined with PCIS for predicting prognosis of pediatric patients with sepsis in the PICU were 0.728, 0.761 and 0.829, respectively (Z=3.744, 6.127, 7.759, all P<0.05). There was significant difference in the AUC between the early lactic acid measurement combined with PCIS and early lactic acid measurement, PCIS(Z=2.114, 2.122, all P<0.05). There was no significant difference in the AUC between the early lactic acid measurement and PCIS(Z=0.480, P>0.05).@*Conclusions@#The early lactic acid measurement and PCIS are effective and able to assess the prognosis of pediatric patients with sepsis in the PICU.It also indicates that the early lactic acid measurement combined with PCIS is more effective.