Abstract:
Objective
To understand the clinical characteristics and prognosis of multiple organ dysfunction syndrome(MODS) caused by sepsis in children.
Methods
This study included 204 children with sepsis hospitalized to PICU in Yuzhou People's Hospital from August 2011 to June 2016，and their involved organs were analyzed; the end-point events(90d death or inevitable death) were followed up.Trend Chi-square test，multiple Cox proportional hazards regression and survival analysis (Kaplan-Meier methods) were performed.
Results
(1)The incidence of MODS was 83 cases［40.69%(95%CI：33.89%-47.48%)］ in 204 children with sepsis. The incidence rate of MODS was 68.75%（11/16），55.10%（27/49），39.62%（21/53），32.61%（15/46） and 22.50%（9/40） for the children at the age of 2 d to 1 month，＞1 month to 1 year，＞1 to 5 years，＞5 to 12 years and ＞12 to 17 years，with significant differences among children at different ages（P<0.05）.(2)The frequency order of involved organs were lung(61 cases，29.90%)，heart(52 cases，25.49%)，blood system(41 cases，20.10%)，nervous system(36 cases，17.65%)，gastrointestinal tract(19 cases，9.31%) and kidney(12 cases，5.88%).The incidence of dysfunction in 2，3 and ≥4 organs was 19 cases(22.89%)，46 cases(55.42%) and 18 cases(21.69%)，respectively.(3)The 90d survival rate of the children with non-MODS，2-，3- and ≥4- organ dysfunction were 87.6%，63.2%，41.3% and 11.1%，respectively，χ2=92.59，P=0.000.After adjusting for age，oxygenation index，etc，multiple Cox proportional hazards regression showed that MODS was an independent factor of prognosis，HR=2.573，6.579，12.699，P＜0.05.
Conclusion
Young children are the high-risk population of MODS caused by sepsis. The main dysfunctional organs were lung，heart and blood system. MODS are the independent factors influencing the 90d survival rate of children with sepsis. Early detection，prevention and cutting off the transmission vicious circle of MODS are important to improve the outcome of child patients.

Key words: Sepsis, Multiple organ dysfunction, Prognosis, Children