Background
Methods
Source of data
Outcome
Study participants
Predictors
Missing data
Statistical analyses
Methodological concept
Statistical software
Model validation
Comparison to previously proposed individual markers
Sensitivity analyses
Results
Study participants
Predictor variable | Sepsis (n = 56) frequency/median (1st quartile-3rd quartile) | Non-infectious SIRS (n = 233) frequency/median (1st quartile-3rd quartile) | p-value (chi squared/Wilcoxon ranksum test) |
---|---|---|---|
Baseline characteristics | |||
Age (months) | 28 (4–105) | 46 (9–120) | 0.129 |
Female sex (n) | 21 | 109 | 0.233 |
Weight (kg) | 11.85 (4.50–27.12) | 15.95 (7.67–32.68) | 0.126 |
Height (cm) | 97 (63–124) | 99 (68–138) | 0.048 |
Indicators of disease severity | |||
PRISM score at PICU admission | 14 (8–19) | 11 (7–17) | 0.155 |
PIM II score at PICU admission | 5 (2–10) | 2 (1–7) | 0.034 |
Clinical parameters | |||
SBP (mmHg) | 80.5 (70–94.75) | 82 (70–94) | 0.763 |
HR (bpm) | 162 (138–180.8) | 151 (133–175) | 0.947 |
CVP (mmHg) | 11 (8–15.5) | 13 (10–16) | 0.178 |
Lactate (mmol/L) | 1.8 (1.4–2.77) | 2 (1.2–3.8) | 0.513 |
Respiratory frequency (per minute) | 25 (15–40) | 22 (15–35) | 0.973 |
SpO2 (%) | 95 (89.25–97) | 96 (94–98) | 0.015 |
Urinary excretion (L per day) | 3.34 (1.62–4.49) | 2.83 (1.88–4.43) | 0.582 |
Core temperature (°C) | 39.15 (38.6–39.32) | 38.7 (38.2–39) | < 0.001 |
Blood gases/ laboratory parameters | |||
pH | 7.41 (7.33–7.46) | 7.39 (7.32–7.45) | 0.388 |
pCO2 (mmHg) | 42 (38–50.25) | 41 (36–47) | 0.433 |
HCO3− (mmol/L) | 25 (23–27.25) | 24 (22–27) | 0.048 |
Leucocyte count (× 109/L) | 11.9 (5.05–18.5) | 13.55 (6.6–18.2) | 0.593 |
Hb (g/dL) | 10.9 (9.5–12.8) | 10.8 (9.5–12.6) | 0.331 |
Platelet count (× 109/L) | 112 (44–288.5) | 169.5 (110.8–239.8) | 0.023 |
INR | 1.42 (1.21–1.67) | 1.33 (1.2–1.62) | 0.28 |
PTT (sec) | 39.5 (34–50) | 35 (31–44.75) | 0.013 |
Fibrinogen (μmol/L) | 3.24 (2.31–4.08) | 2.6 (1.75–3.8) | 0.018 |
d-dimer (ng/mL) | 5008 (2328–11,240) | 2733 (1224–5726) | 0.001 |
CRP (mg/L) | 48 (30–85.5) | 33.5 (12.25–72) | 0.009 |
IL-6 (ng/L) | 118 (40–412) | 52 (22–122.5) | 0.001 |
PCT (μg/L) | 2.55 (0.48–8.45) | 1 (0.3–4.17) | 0.020 |
AST (U/L) | 75 (34.5–146.5) | 73.5 (40–182.5) | 0.388 |
ALT (U/L) | 43.5 (16.25–93.5) | 32 (18–71.5) | 0.295 |
Phosphate (mmol/L) | 1.54 (1.24–1.86) | 1.64 (1.27–2.02) | 0.238 |
Creatinine (μmol/L) | 33.5 (26.25–61.5) | 44.5 (31–65) | 0.079 |
Urea (mmol/L) | 7.55 (3.92–11.25) | 6.2 (4–10.5) | 0.285 |
Technical ICU support | |||
Mechanical ventilation (n) | 55 (98%) | 221 (95%) | 0.474 |
Central venous catheter (n) | 43 (77%) | 201 (86%) | 0.099 |
Number of peripheral IV cannulas | 2 (1–2) | 2 (1–2) | 0.972 |
In-line filter application (allocation to interventional group in NCT00209768; ClinicalTrials.gov number) | 24 (43%) | 102 (44%) | 1 |
Medical/ surgical treatment | |||
Antibiotics (n) | 49 (88%) | 195 (84%) | 0.545 |
Steroids (n) | 17 (30%) | 45 (19%) | 0.101 |
Catecholamines (n) | 24 (43%) | 132 (57%) | 0.074 |
FiO2 | 0.3 (0.25–0.5) | 0.35 (0.24–0.5) | 0.806 |
Surgery before PICU admission (n) | 40 (71%) | 171 (73%) | 0.741 |
Sepsis/ SIRS related factors | |||
Length of PICU stay until onset of SIRS/ sepsis (days) | 15 (6–41) | 2 (1–9) | < 0.001 |
Cumulative sepsis or SIRS episodes (n) | < 0.001 | ||
0 | 31 | 199 | |
1 | 14 | 24 | |
2 | 7 | 6 | |
3 | 2 | 4 | |
4 | 2 | 0 | |
Total SIRS episodes (n) | 0.003 | ||
0 | 40 | 203 | |
1 | 11 | 23 | |
2 | 4 | 6 | |
3 | 1 | 1 | |
Total sepsis episodes (n) | < 0.001 | ||
0 | 43 | 223 | |
1 | 9 | 10 | |
2 | 2 | 0 | |
3 | 1 | 0 | |
4 | 1 | 0 |
Model development
Variable | Variable importance measurea |
---|---|
Length of PICU stay until onset of non-infectious SIRS/sepsis | 0.031 |
Interleukin-6 | 0.017 |
Platelet count | 0.010 |
Procalcitonin | 0.008 |
Cumulative sepsis or non-infectious SIRS episodes (n) | 0.007 |
Core temperature | 0.005 |
C-reactive protein | 0.005 |
Central venous catheter | 0.004 |