Journal of Emergencies, Trauma, and Shock

ORIGINAL RESEARCH PAPER
Year
: 2019  |  Volume : 12  |  Issue : 4  |  Page : 274--279

Effect of prehospital transport factors on shock index, serum lactate, and mortality in children with septic shock: A prospective observational study


Jhuma Sankar1, Rashmi Ranjan Das2, Archana Singh3 
1 Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
2 Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
3 Department of Pediatrics, PGIMER, Dr. RML Hospital, New Delhi, India

Correspondence Address:
Dr. Rashmi Ranjan Das
Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar - 751 019, Odisha
India

Context: Many children with septic shock either present late or are recognized late due to various reasons. Shock index (SI) is a valuable screening tool in dentifying high-risk septic patients in emergency department. Whether prehospital transport factors affect SI and clinical outcomes has not been evaluated. Aim: Our aim was to evaluate if prehospital transport-related factors such as mode of transport and referral from another hospital affect the admission SI and mortality in children with septic shock. Settings and Design: Prospective observational study conducted over 1-year period in the Pediatric Emergency and Intensive Care Unit of a tertiary care teaching hospital. Subjects and Methods: Children < 17 years of age were evaluated. Data collection included referral status, mode of transport, physiologic (SI and serum lactate), and clinical parameters. Statistical Analysis Used: Student's t-test was used for analyzing continuous variables. Chi-square/Fischer's exact test was used for analysis of categorical variables. P < 0.05 was considered as statistically significant. Results: Of 51 children, 21 (41%) were referred from other hospitals. Of these, less than half were transported by ambulance unaccompanied by any healthcare personnel. Twenty-six children (43%) died, of which 15 (71%) were referred. The median serum lactate, SI, and mortality were significantly higher in those referred. On multivariate analysis of factors associated with mortality, elevated SI and/or lactate >4 mmol/L and the “referral” status remained significant after adjusting for baseline variables and illness severity. Conclusions: Children with septic shock referred from other hospitals had higher SI, serum lactate, and mortality rates. Our study highlights the need for improving prehospital care and transportation in children with septic shock.


How to cite this article:
Sankar J, Das RR, Singh A. Effect of prehospital transport factors on shock index, serum lactate, and mortality in children with septic shock: A prospective observational study.J Emerg Trauma Shock 2019;12:274-279


How to cite this URL:
Sankar J, Das RR, Singh A. Effect of prehospital transport factors on shock index, serum lactate, and mortality in children with septic shock: A prospective observational study. J Emerg Trauma Shock [serial online] 2019 [cited 2020 Jun 1 ];12:274-279
Available from: http://www.onlinejets.org/article.asp?issn=0974-2700;year=2019;volume=12;issue=4;spage=274;epage=279;aulast=Sankar;type=0