GIÁ TRỊ TIÊN LƯỢNG CỦA CHỈ SỐ SỐC Ở TRẺ SỐC NHIỄM KHUẨN TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ

Abstract

Backgroud: The mortality rate due to septic shock remains high. The shock index (SI) is a simple tool, easy to measure and calculate, which is the ratio between heart rate and systolic blood pressure. SI has been shown to predict mortality in pediatric patients with septic shock. Objectives: To investigate the mortality prediction value of the shock index in children with septic shock at Can Tho Children's Hospital. Materials and methods: Research on 39 children diagnosed with septic shock between April 2021 and July 2022 in the Intensive Care Unit of Can Tho Children's Hospital. We evaluated SI values at 0 hours and after 6 hours of admission. Results: The male/female ratio is 2/1, 0-<2 years old group accounts for the majority (35.9%), the gastrointestinal infection is the most common (51.3%). The mortality rate is 64.1%, the rate of multi-organ dysfunctions is 89.7%. SI at 0 hour was not different in both living and deceased groups, SI at 6 hours was statistically significantly higher in the non-survivor group. No statistically significant difference in SI at 2 times was recorded in both groups with and without multi-organ dysfunctions. SI at 6 hours had the best separation ability with AUC=0.731, p<0.05, with cutoff of >1.58. The specificity is quite high (92.9%) with a negative likelihood ratio of 0.34. Conclusion: Shock index may be promising as a indicator of mortality in children with septic shock. An increased shock index at 6 hours after admission is related to the mortality rate and the shock index at this time has quite good value in predicting death in children with septic shock.