Journal article
The Association of Nutrition Status Expressed as Body Mass Index z Score With Outcomes in Children With Severe Sepsis: A Secondary Analysis From the Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study
Critical care medicine, Vol.46(11), pp.E1029-E1039
11/01/2018
DOI: 10.1097/CCM.0000000000003351
PMCID: PMC6185775
PMID: 30095495
Abstract
Objectives: The impact of nutrition status on outcomes in pediatric severe sepsis is unclear. We studied the association of nutrition status (expressed as body mass index z score) with outcomes in pediatric severe sepsis.
Design: Secondary analysis of the Sepsis Prevalence, Outcomes, and Therapies study. Patient characteristics, ICU interventions, and outcomes were compared across nutrition status categories (expressed as age- and sex-adjusted body mass index z scores using World Health Organization standards). Multivariable regression models were developed to determine adjusted differences in all-cause ICU mortality and ICU length of stay by nutrition status.
Setting: One-hundred twenty-eight PICUs across 26 countries.
Patients: Children less than 18 years with severe sepsis enrolled in the Sepsis Prevalence, Outcomes, and Therapies study (n = 567).
Interventions: None.
Measurements and Main Results: Nutrition status data were available for 417 patients. Severe undernutrition was seen in Europe (25%), Asia (20%), South Africa (17%), and South America (10%), with severe overnutrition seen in Australia/New Zealand (17%) and North America (14%). Severe undernutrition was independently associated with all-cause ICU mortality (adjusted odds ratio, 3.0; 95% CI, 1.2-7.7; p = 0.02), whereas severe overnutrition in survivors was independently associated with longer ICU length of stay (1.6 d; p = 0.01).
Conclusions: There is considerable variation in nutrition status for children with severe sepsis treated across this selected network of PICUs from different geographic regions. Severe undernutrition was independently associated with higher all-cause ICU mortality in children with severe sepsis. Severe overnutrition was independently associated with greater ICU length of stay in childhood survivors of severe sepsis.
Details
- Title: Subtitle
- The Association of Nutrition Status Expressed as Body Mass Index z Score With Outcomes in Children With Severe Sepsis: A Secondary Analysis From the Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study
- Creators
- Sharon Y. Irving - University of PennsylvaniaBridget Daly - University of PennsylvaniaJudy Verger - University of PennsylvaniaKatri V. Typpo - University of ArizonaAnn-Marie Brown - Boston Children's HospitalAlexandra Hanlon - University of PennsylvaniaScott L. Weiss - University of PennsylvaniaJulie C. Fitzgerald - University of PennsylvaniaVinay M. Nadkarni - University of PennsylvaniaNeal J. Thomas - Pennsylvania State UniversityVijay Srinivasan - University of PennsylvaniaSepsis Prevalence, Outcomes, and Therapies (SPROUT) Study InvestigatorsPediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
- Contributors
- M Chegondi (Contributor) - University of Iowa, Stead Family Department of PediatricsC Tigges (Contributor) - University of Iowa, Critical Care
- Resource Type
- Journal article
- Publication Details
- Critical care medicine, Vol.46(11), pp.E1029-E1039
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/CCM.0000000000003351
- PMID
- 30095495
- PMCID
- PMC6185775
- ISSN
- 0090-3493
- eISSN
- 1530-0293
- Number of pages
- 11
- Grant note
- Center for Pediatric Clinical Effectiveness at the Children's Hospital of Philadelphia Bristol-Myers Squibb Company; Bristol-Myers Squibb NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA CareFusion Children's Hospital of Philadelphia (CHOP) Southampton NIHR Wellcome Trust Clinical Research Facility CHOP Center for Pediatric Clinical Effectiveness Gene Fluidics Endowed Chair, Department of Anesthesia and Critical Care, University of Pennsylvania Perelman School of Medicine Medscape via Roche Therabron Center for Pediatric Clinical Effectiveness at CHOP K23GM110496 / National Institute of General Medical Sciences; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS) Biostatistics Consulting Unit at the University of Pennsylvania School of Nursing National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) Baxter U.K. National Institute of Health (NIHR) Clinical Research Network K23DK106462 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Language
- English
- Date published
- 11/01/2018
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics; Nursing
- Record Identifier
- 9984353945002771
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