Pediatric Reports
Plasma Vitamin C, 25-Hydroxyvitamin D, and the Lactate-to-Albumin Ratio at PICU Admission in Survivors and Non-Survivors of Phoenix-Defined Pediatric Sepsis and Septic Shock: An Exploratory Prospective Cohort Study
By Jesús J. Martínez-García, Adrián Canizalez‐Román, Ricardo Zatarain-Lopez and 11 others.
Abstract
Background
Vitamin C, 25-hydroxyvitamin D (25[OH]D), and the lactate-to-albumin ratio (LAR) have been proposed as prognostic markers in sepsis. However, pediatric data are limited, and these markers have not been evaluated together in a cohort classified according to the Phoenix criteria. We quantified these markers at pediatric intensive care unit (PICU) admission and assessed their unadjusted association with mortality.
Methods
This single-center prospective cohort study followed the STROBE statement. We enrolled consecutive children aged 1 month to 17 years with suspected infection and a Phoenix Sepsis Score of at least 2; septic shock required at least one cardiovascular point. Blood was sampled within 1 h of admission. We analyzed ascorbate by ultra-high-performance liquid chromatography coupled with mass spectrometry in light-protected heparin plasma. The endpoint was pre-discharge PICU mortality. We expressed differences as Hodges–Lehmann estimates with exact 95% confidence intervals (CIs), and discrimination as the area under the receiver operating characteristic curve (AUC). The five principal biomarker comparisons were subjected to Benjamini–Hochberg false discovery rate (FDR) control. We fitted no multivariable model (11 events).