Índice de choque y nivel de la lactato en sangre como predictores de mortalidad en pacientes con shock séptico ingresados en la Unidad de Terapia Intensiva Pediátrica del Hospital de Niños "Dr. Roberto Gilbert Elizalde", de marzo a agosto del 2020, de la ciudad de Guayaquil.

Abstract

Background: Septic shock is an important cause of morbidity and mortality, predictive methods have been created to assess mortality risk, resulting in effective prognostic indices. Objective: To evaluate the usefulness of the shock index and the lactate level as predictors of mortality in pediatric patients with septic shock admitted to the PICU of the Children's Hospital “Dr. Roberto Gilbert Elizalde. Materials and methods: Observational, prospective, longitudinal, analytical study with 60 medical records of patients with septic shock. Qualitative variables were analyzed with frequencies and percentages, quantitative variables with dispersion and correlation with Chi2, the discriminative capacity of shock index (SI), lactate and PIM 3 to predict mortality by calculating ROC curve. Results: The mean age was 67.28 months (SD±63.6), male (60%), minor infants age group (33.3%). Among living discharges, 61.1% were male, 31.5% minor infants, 33.3% hospital stay <7 days. The mean of the highest SI was in the Emergency (1.74 SD±0.68). The highest mean lactate was at admission to the PICU (2.23 SD±1.93). The time from admission to the Emergency room and admission to the PICU had a mean of 21.7 (SD±41.1) hours. Low lactate level and PIM 3 were associated with live discharge status (p<0.05). The highest discriminative capacity of lactate to predict mortality was 0.881 at 24 hours, PIM 3 0.809, SI at 2 hours 0.722. The recorded mortality was 10%. Conclusions: Shock index and lactate are good predictors of mortality in pediatric patients with septic shock admitted to the PICU.