Body Habitus and Risk of Mortality in Pediatric Sepsis and Septic Shock: A Retrospective Cohort Study

To investigate the association between body habitus and mortality in critically ill children with sepsis or septic shock. This was a retrospective cohort study of prospectively collected data of children admitted to US pediatric intensive care units (PICUs) with a primary or secondary diagnosis of s...

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Bibliographic Details
Published in:The Journal of pediatrics 2019-07, Vol.210, p.178-183.e2
Main Authors: Ross, Patrick A., Klein, Margaret J., Nguyen, Tuan, Leung, Dennis, Khemani, Robinder G., Newth, Christopher J.L., Bhalla, Anoopindar K.
Format: Article
Language:English
Subjects:
Adolescent
body habitus
Child
Child, Preschool
Cohort Studies
Female
Humans
Infant
Infant, Newborn
intensive care
Intensive Care Units, Pediatric
Length of Stay - statistics & numerical data
Male
mortality
Overweight - epidemiology
Pediatric Obesity - epidemiology
pediatrics
Respiration, Artificial - statistics & numerical data
Retrospective Studies
sepsis
Sepsis - mortality
septic shock
Shock, Septic - mortality
United States - epidemiology
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Summary:To investigate the association between body habitus and mortality in critically ill children with sepsis or septic shock. This was a retrospective cohort study of prospectively collected data of children admitted to US pediatric intensive care units (PICUs) with a primary or secondary diagnosis of sepsis or septic shock. We separated body habitus into underweight, normal weight, overweight, and obese. Outcomes were mortality (primary), treatment with invasive mechanical ventilation (secondary), and time to PICU discharge for survivors (secondary). Multivariable analyses using mixed-effects logistic regression and shared frailty models clustered by unit and adjusted for confounding variables were used to assess the association between body habitus and outcomes. There were 7038 children with sepsis or septic shock. Mortality was 10.1% (n = 714) and 52.9% (n = 3720) required invasive mechanical ventilation. Body habitus was not associated with mortality after controlling for hospital level effects and confounding variables. Children who were overweight and obese had greater odds of invasive mechanical ventilation (overweight OR 1.23 [95% CI 1.05-1.45], P = .011 and obese OR 1.57 [95% CI 1.37-1.80], P 
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2019.03.027