ArticleJournal of emergencies, trauma, and shock
Effect of Prehospital Transport Factors on Shock Index, Serum Lactate, and Mortality in Children with Septic Shock: A Prospective Observational Study.
Article in Journal of emergencies, trauma, and shock. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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3 authors.
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Abstract
contextMany children with septic shock either present late or are recognized late due to various reasons. Shock index (SI) is a valuable screening tool in dentifying high-risk septic patients in emergency department. Whether prehospital transport factors affect SI and clinical outcomes has not been evaluated.
aimOur aim was to evaluate if prehospital transport-related factors such as mode of transport and referral from another hospital affect the admission SI and mortality in children with septic shock. SETTINGS AND
designProspective observational study conducted over 1-year period in the Pediatric Emergency and Intensive Care Unit of a tertiary care teaching hospital. SUBJECTS AND
methodsChildren < 17 years of age were evaluated. Data collection included referral status, mode of transport, physiologic (SI and serum lactate), and clinical parameters. STATISTICAL ANALYSIS USED: Student's
resultsOf 51 children, 21 (41%) were referred from other hospitals. Of these, less than half were transported by ambulance unaccompanied by any healthcare personnel. Twenty-six children (43%) died, of which 15 (71%) were referred. The median serum lactate, SI, and mortality were significantly higher in those referred. On multivariate analysis of factors associated with mortality, elevated SI and/or lactate >4 mmol/L and the "referral" status remained significant after adjusting for baseline variables and illness severity.
conclusionsChildren with septic shock referred from other hospitals had higher SI, serum lactate, and mortality rates. Our study highlights the need for improving prehospital care and transportation in children with septic shock.
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