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Open Access 01-10-2007 | Research

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

Authors: Martine Maat, Corinne MP Buysse, Marieke Emonts, Lodewijk Spanjaard, Koen FM Joosten, Ronald de Groot, Jan A Hazelzet

Published in: Critical Care | Issue 5/2007

Abstract

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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Title: Improved survival of children with sepsis and purpura: effects of age, gender, and era
Authors: Martine Maat
Corinne MP Buysse
Marieke Emonts
Lodewijk Spanjaard
Koen FM Joosten
Ronald de Groot
Jan A Hazelzet
Publication date: 01-10-2007
Publisher: BioMed Central
Published in: Critical Care / Issue 5/2007
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc6161

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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