{
    "abstract": "La sepsis en pediatr\u00eda es la principal causa de muerte hospitalaria. Se han intentado crear herramientas que faciliten su identificaci\u00f3n, como el \u00edndice de choque (IC), definido como el cociente entre frecuencia card\u00edaca y tensi\u00f3n arterial sist\u00f3lica. El objetivo de este trabajo fue identificar el mejor momento del IC para predecir la mortalidad en pacientes pedi\u00e1tricos con sepsis grave y choque s\u00e9ptico.\nCohorte retrospectiva con 165 pacientes pedi\u00e1tricos que desarrollaron sepsis grave y choque s\u00e9ptico en la Unidad de Terapia Intensiva Pediatrica. Se calcul\u00f3 el IC al diagn\u00f3stico (IC0), a las dos, cuatro y seis horas posteriores al mismo (IC2, IC4 e IC6). Se crearon dos grupos seg\u00fan el desenlace (sobrevivientes/muertos). La comparaci\u00f3n estad\u00edstica se realiz\u00f3 con prueba U-Mann Whitney y \u03c7\nSe compar\u00f3 el valor del IC entre grupos; en el grupo de choque s\u00e9ptico, el IC se encontr\u00f3 m\u00e1s elevado en IC4 e IC6 (p = 0.010 y p = 0.005). Se encontr\u00f3 que, en los pacientes muertos, el IC increment\u00f3 progresivamente su valor en IC4 e IC6 (p < 0.05). Los valores de IC4 e IC6 elevados incrementaron el riesgo de muerte en los pacientes (IC4, RM: 442.1; IC 95% [intervalo de confianza al 95%]: 54.2-3,601.7; p < 0.001; e IC6, RM: 81,951.3; IC 95%: 427.1-15,700,000; p < 0.001).\nLa elevaci\u00f3n del valor del IC se asocia con mayor mortalidad de la sepsis. El valor de IC6 es el m\u00e1s \u00fatil para predecir mortalidad.\nPediatric sepsis is considered the main cause of hospital death around the world. Many groups have tried to create tools that facilitate its early identification, as the shock index (SI) defined as the ratio between cardiac frequency and systolic blood pressure. The objective of this study was to determine the utility of SI to predict mortality in pediatric patients with severe sepsis and septic shock.\nRetrospective cohort with 165 pediatric patients with severe sepsis or septic shock in the Pediatric Intensive Care Unit. SI was calculated at diagnosis, 2, 4 and 6 hours after (SI2, SI4 and SI6). We divided the population in two groups depending their outcome: survivors and non-survivors. The statistical analysis was performed with U Mann-Whitney and chi squared tests. The risk factors were compared between the survivors and the dead, and we calculated the odds ratio (OR).\nThe median value of SI was compared between groups; in the group of septic shock, SI showed a tendency to remain high in SI4 and SI6 (p = 0.010 and p = 0.005, respectively). Among the survivors and the non-survivors, we found that in the latter, SI was progressively increased in SI4 and SI6 (p < 0.05). High values of SI4 and SI6 increased the risk of death in patients (SI4: OR: 442.1; CI 95% [confidence interval 95%]: 54.2-3,601.7; p < 0.001 and SI6: OR: 81,951.3; CI 95%: 427.1-15,700,000]; p < 0.001).\nHigh values of SI are associated with increased mortality. The IS6 value is the most useful to predict mortality.",
    "authors": [
        {
            "affiliation": "Unidad de Terapia Intensiva Pedi\u00e1trica. Unidad M\u00e9dica de Alta Especialidad, Hospital de Pediatr\u00eda Dr. Silvestre Frenk Freund, Centro M\u00e9dico Nacional Siglo XXI, Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Claudia S",
            "initials": "CS",
            "lastname": "L\u00f3pez-Reyes"
        },
        {
            "affiliation": "Unidad de Terapia Intensiva Pedi\u00e1trica. Unidad M\u00e9dica de Alta Especialidad, Hospital de Pediatr\u00eda Dr. Silvestre Frenk Freund, Centro M\u00e9dico Nacional Siglo XXI, Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Lilia N",
            "initials": "LN",
            "lastname": "Baca-Vel\u00e1zquez"
        },
        {
            "affiliation": "Unidad de Investigaci\u00f3n M\u00e9dica en Epidemiolog\u00eda Cl\u00ednica. Unidad M\u00e9dica de Alta Especialidad, Hospital de Pediatr\u00eda Dr. Silvestre Frenk Freund, Centro M\u00e9dico Nacional Siglo XXI, Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Miguel A",
            "initials": "MA",
            "lastname": "Villasis-Keever"
        },
        {
            "affiliation": "Unidad de Investigaci\u00f3n en Nutrici\u00f3n. Unidad M\u00e9dica de Alta Especialidad, Hospital de Pediatr\u00eda Dr. Silvestre Frenk Freund, Centro M\u00e9dico Nacional Siglo XXI, Ciudad de M\u00e9xico, M\u00e9xico.",
            "firstname": "Jessie N",
            "initials": "JN",
            "lastname": "Zurita-Cruz"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright: \u00a9 2018 Secretar\u00cda de Salud.",
    "doi": "10.24875/BMHIM.M18000027",
    "journal": "Boletin medico del Hospital Infantil de Mexico",
    "keywords": [
        "Choque s\u00e9ptico",
        "Sepsis grave",
        "Septic shock",
        "Severe sepsis",
        "Shock index",
        "\u00cdndice de choque"
    ],
    "methods": null,
    "publication_date": "2018-08-08",
    "pubmed_id": "30084442",
    "results": "The median value of SI was compared between groups; in the group of septic shock, SI showed a tendency to remain high in SI4 and SI6 (p = 0.010 and p = 0.005, respectively). Among the survivors and the non-survivors, we found that in the latter, SI was progressively increased in SI4 and SI6 (p < 0.05). High values of SI4 and SI6 increased the risk of death in patients (SI4: OR: 442.1; CI 95% [confidence interval 95%]: 54.2-3,601.7; p < 0.001 and SI6: OR: 81,951.3; CI 95%: 427.1-15,700,000]; p < 0.001).",
    "title": "[Utilidad del \u00edndice de choque para predecir la mortalidad en pacientes pedi\u00e1tricos con sepsis grave o choque s\u00e9ptico].",
    "xml": "<Element 'PubmedArticle' at 0x7885028a1580>"
}