PROGNOSTIC VALUE OF SHOCK INDEX IN CHILDREN WITH SEPTIC SHOCK

Introduction: Septic shock in pediatric age group is likely due to result of sequence of disorders that is due to infection by viruses, bacteria, parasite, fungi or toxins of organisms.  The outcome is improved with early recognition and resuscitation of sepsis and septic shock in the golden first few hours of PICU admission. Hence, we conducted this retrospective surgery between PICU shock index in ICU mortality and morbidity.

Material & Methods: The study was retrospective and performed in 1 paediatric intensive care unit in Department of Paediatrics, A. J Hospital, Mangalore, Karnataka.The following specimen data were collected 0,2,4,6,hours after admission : HR and SBP for SI calculation. Patients were divided into 2 groups according to their outcome(death/survival)

Results: A total of 75 children admitted with septic shock between June 2018 and May 2020 were included.Shock index was significantly different between survivors and non survivors at 0,2,4,6 hours of admission (P-0.003,P-0.029,P-0.043,P-0.006 respectively) compared to HR and SBP alone separately. The cutoff point of SI for death in our study at 0 hours is < 1.7 with sensitivity of 63.6% and specificity of 62.3%, at 2 hours cutoff is <1.6 with sensitivity of 68% and specificity of 70%, at 4 hrs cutoff is < 1.55 with sensitivity of 68% and specificity of 66%, at 6 hours cutoff is < 1.5 with sensitivity of 72.7% and specificity of 68%.

Conclusions: In our population of children with septic shock, SI was a clinically relevant and easily calculated predictor of mortality.It could be better measure of hemodynamic status than HR and SBP alone, allowing for early recognition of severe sepsis.