Pediatric Shock: The Magnitude, Its Determinants and Short-Term Outcome on Patients. A Cross-Sectional Hospital-Based Study

Abstract

Background

Pediatric shock is a potentially fatal illness which develops after a systemic circulatory system failure in children. It appears to be a common emergency in children and produces substantial morbidity and mortality particularly if there is no early identification and therapy. The extent and causes of shock-induced death among children in Ethiopia have not been sufficiently studied.

Objective

This study was conducted to evaluate the magnitude, determinants and short-term outcome of shock in pediatric patients who visited Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia.

Methods

From October 1, 2020, to July 30, 2022, an observational cross-sectional study was carried out at Ayder Comprehensive Specialized Hospital. The study included 132 children from the age of 1 month to 18 years. According to pediatric advanced life support guidelines, shock was diagnosed among patients. To gather information, a pretested questionnaire was employed. To examine the relationship between the independent variables and shock outcome, bivariate logistic regression was performed, and statistical significance was defined as a P-value of 0.05 or lower.

Results

The prevalence of shock was 2.2%. This study revealed 70.5% decompensated stage of shock. Mortality rate of shock was 45.5% (95% CI: 37.1–53.8). A delayed presentation by more than one week with an adjusted odd ratio (AOR) of 16.9 (95% CI: 2.3–123), type of shock other than hypovolemic shock with AOR of 8.3 (95% CI: 1.4–48), stage of shock with AOR of 27.8 (95% CI: 2.8–157), requirement of mechanical ventilation with AOR of 11 (95% CI: 2.6–53) and length of hospital stay less than three days with AOR of 9 (95% CI: 1.7–48) were identified as a predictor of mortality by shock in children.

Conclusion

According to this study, shock causes a high rate of child mortality. Independent predictors of mortality included delayed presentation, shock type, stage of shock, the need for mechanical ventilation, and brief hospital stay (less than three days).

Keywords:

• shock
• children
• cross-sectional study
• Ayder Hospital

Data Sharing Statement

All data related to this study are contained in this paper.

Acknowledgments

The authors would like to acknowledge medical residents and internship team at Ayder Specialized Hospital, Department of Pediatrics and Child Health for their support in data collection during the study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

There is no funding to report.