The magnitude, determinants, and outcome of shock among pediatric patients: A cross-sectional hospital-based study

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Abstract Background Pediatric shock, a potentially fatal illness, develops after a systemic circulatory system failure. 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 severity, determinants, and prognosis of shock in pediatric patients who visited Ayder Comprehensive Specialized Hospital in Tigray, Northern Ethiopia. Methods From October 1st, 2020, to July 30th, 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. Result The prevalence of shock was 2.2%. This study revealed 70.4 % 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 higher rate of child mortality. Independent predictors of mortality included delayed presentation, shock type, shock stage, need for mechanical ventilation, and brief hospital stay (less than three days).

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