Nested case-control study of multiple serological indexes and Brighton pediatric early warming score in predicting death of children with sepsis

Table 1 The inclusion criteria and exclusion criteria

Inclusion criteria	Exclusion criteria
Data completed within 24 h after admission	Previously diagnosed with tumor disease
Age > 28 d	Previously diagnosed with autoimmune disease

Table 2 Brighton pediatric early warming score scoring criteria

Project	0 Points	1 Point	2 Points	3 Points
Behavior	Normal	Somnolence	Irritability	Lethargy/coma
				Reduced pain response
Cardiovascular system	Pink skin	Pale skin	Gray skin	Cold skin, clammy skin
	CRT 1-2 s	CRT 3 s	CRT 4 s	CRT ≥ 5 s
			Heart rate increased 20 times/min	Heart rate increased 20 times/min or bradycardia
Respiratory system	Normal	Normal respiratory frequency	Normal respiratory frequency	Normal respiratory frequency
	Air-free depression	Increased 10 times/min, FiO2 0.3, or oxygen inhalation flow 4 L/min	Increased 20 times/min, inspiratory depression, FiO2 0.4, or oxygen inhalation flow 4 L/min	Reduced 5 times/min, with sternal inspiratory depression, moaning, FiO2 0.5, or oxygen inhalation flow 8 L/min

CRT: Cardiac resynchronization therapy.

Table 3 Comparison between the observation group and control group at the time of admission n (%)

	Control group (n = 48)	Observation group (n = 48)	t/χ2	P-value
Baseline data
Age (yr)	2.48 ± 1.71	2.51 ± 1.79	0.084	0.933
Gender (male/female)	32/16	32/16	0.000	1.000
Temperature (°C)	37.58 ± 1.03	38.26 ± 1.45	1.597	0.114
Weight (kg)	15.24 ± 2.68	14.39 ± 1.47	1.927	0.057
Primary infection site
Pulmonary infection	28 (58.3)	31 (64.6)	0.396	0.529
Digestive system infections	17 (35.4)	16 (33.3)	0.046	0.830
Blood system infection	10 (20.8)	7 (14.6)	0.643	0.423
Basic disease
Blood system diseases	33 (70.2)	32 (66.7)	0.048	0.827
Congenital heart disease	11 (22.9)	8 (16.7)	0.591	0.442
Treatment measures
Antibacterial treatments within 1 h	40 (83.3)	33 (68.8)	2.802	0.094
Duration of mechanical ventilation (h)	83.41 ± 35.17	144.36 ± 52.55	6.678	0.000
Duration of vasoactive drug maintenance (h)	74.02 ± 31.90	78.16 ± 42.56	0.539	0.591
Complication
ARDS	13 (27.1)	15 (31.3)	0.202	0.653
Shock	21 (43.8)	35 (72.9)	8.400	0.004
Number of organs with dysfunction	1.76 ± 0.78	3.42 ± 1.51	6.767	0.000
Laboratory examination
WBC (×109/L)	13.96 ± 2.85	12.74 ± 3.21	1.969	0.052
PLT (×109/L)	107.38 ± 33.70	85.26 ± 45.35	2.712	0.008
Hb (g/L)	105.03 ± 20.25	104.42 ± 22.19	0.141	0.888
PCT (ng/mL)	7.48 ± 4.51	19.97 ± 6.38	11.177	0.000
CRP (ng/mL)	115.67 ± 66.23	135.14 ± 77.62	1.324	0.189
ALB (g/L)	40.11 ± 2.57	33.57 ± 4.97	8.098	0.000
sCD163 (mg/L)	165.31 ± 175.26	253.66 ± 216.81	2.196	0.031
DD (μg/L)	802.16 ± 269.08	1648.93 ± 502.55	10.282	0.000
Lac (mmol/L)	3.22 ± 2.13	7.69 ± 5.24	5.475	0.000
Cr (μmol/L)	452.56 ± 348.72	336.15 ± 356.80	1.617	0.109
Children's score
PEWS	5.35 ± 1.89	7.22 ± 1.43	5.467	0.000

ARDS: Acute respiratory distress syndrome; WBC: White blood cells; PLT: Platelets; Hb: Hemoglobin; PCT: Serum procalcitonin; CRP: C-reactive protein; ALB: Serum albumin; DD: D-dimer; Lac: serum lactic acid value; Cr: Creatinine; PEWS: Pediatric early warning score.

Table 4 Multivariate logistic analysis of death in children with sepsis

	Assignment	P	OR	95%CI
Antibacterial treatments within 1 h	Yes = 0, No = 1	0.017	1.654	1.620-1.892
Duration of mechanical ventilation	-	0.182	1.679	0.848-2.675
Shock	No = 0, Yes = 1	0.044	1.574	1.388-3.043
Number of organs with dysfunction	-	0.027	2.101	1.615-2.013
PLT (109/L)	-	0.126	1.086	0.821-1.678
PCT (ng/mL)	-	0.047	1.283	1.434-1.792
ALB (g/L)	-	0.024	0.842	0.323-2.806
sCD163 (mg/L)	-	0.563	1.558	0.466-3.850
DD (μg/L)	-	0.180	1.149	0.709-1.251
Lac (mmol/L)	-	0.115	1.435	0.562-1.785
PEWS	-	0.012	2.476	1.153-2.617

PLT: Platelets; PCT: Serum procalcitonin; ALB: Serum albumin; DD: D-dimer; Lac: serum lactic acid value; PEWS: Pediatric early warning score.