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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Critical Care
Volume 12 - 2024 | doi: 10.3389/fped.2024.1455216

Prognostic significance of blood immune cells in children with sepsis and establishment of a predictive model for PICU mortality: a retrospective study

Provisionally accepted
Mulan He Mulan He Qiuxia Meng Qiuxia Meng *Zhixin Wei Zhixin Wei Zhiyong Yang Zhiyong Yang *
  • First Affiliated Hospital, Guangxi Medical University, Nanning, China

The final, formatted version of the article will be published soon.

    Objectives.: This article aimed to investigate the correlation between blood immune cells and the prognosis in the early phase of pediatric sepsis and construct a prediction model for pediatric intensive care unit (PICU) mortality.A total of 348 children admitted with sepsis to our PICU were retrospectively collected between January 2020 and June 2024. Of these, 242 children admitted from January 2020 to October 2022 were designated as the modeling group, while 106 children admitted between November 2022 and June 2024 were designated as the prospective validation group. Peripheral blood immune-related parameters, measured from the day of PICU admission to day 7, were analyzed in the modeling group. Risk factors were identified through multivariate logistic regression and integrated into a predictive nomogram. The nomogram was then applied to the prospective validation group to assess its discrimination and calibration. The nomogram's performance was evaluated using the area under the receiver operating characteristic curves (AUC), calibration plots, and decision curve analysis for both groups.Results: Complicated with underlying diseases, invasive mechanical ventilation, increased pediatric risk of mortality score or pediatric sequential organ failure assessment score, and lymphopenia (d1) were independent risk factors for PICU mortality. The 90-day survival of patients with lymphopenia on the first day after admission was low. In addition, patients with persistent lymphopenia had higher mortality. The nomogram showed an AUC of 0.861 (95% CI 0.813 to 0.909) in the modeling group and 0.875 (95% CI 0.797 to 0.953) in the prospective validation group. The nomogram also performed well based on the calibration curve and decision curve analysis.Assessing lymphocytes within seven days of PICU admission may be conducive to identifying children with sepsis at increased mortality risk. The nomogram performed well in predicting PICU mortality among patients of interest.

    Keywords: Sepsis, Children, predictive model, Lymphocytes, PICU mortality

    Received: 26 Jun 2024; Accepted: 30 Nov 2024.

    Copyright: © 2024 He, Meng, Wei and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Qiuxia Meng, First Affiliated Hospital, Guangxi Medical University, Nanning, China
    Zhiyong Yang, First Affiliated Hospital, Guangxi Medical University, Nanning, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.