Prognostic Value Of Shock Index In Children With Sepsis/ Septic Shock

Abstract

Objective- To investigate the association between PICU shock index and mortality in children with sepsis/septic shock and to explore cut off values for ICU mortality, how change in shock index over the first 6 hours of ICU admission is associated with outcome. Methods- 50 children who presented with sepsis/ septic shock were included in the study. Children were classified as per their age as < 1 year,> 1 year - < 6 years and > 6 years.They were also grouped as sepsis, severe sepsis and septic shock as per the International Sepsis Consensus Conference definition of sepsis in 2005. Clinical parameters like heart rate and systolic blood pressure was recorded, following which shock index was calculated over 0,1,2,4 and 6 hours of PICU admission and trend was noticed.Patients were finally divided into 2 groups as per outcome, i.e. survival/ death. Results : Data analysis was done using GraphPad Prism 5. Cut-off values of shock index were analysed using Receiver Operator Curve and their relative risk of mortality was studied. Higher values of shock index and increasing trend of shock index was associated with increased mortality. Conclusion : SI can be a promising marker for risk of mortality in children with sepsis/ septic shock. It is simple, non-invasive and bedside clinical tool to identify high-risk children and help us keep vigilant.The obtained cut-off values indicate that higher the SI,higher is the risk of mortality.