484 - Association Between Asthma and Prognosis of Critically Ill Pediatric Patients with Concern for Sepsis

Publication Number: 484.3943

Leona R. Montero, Cohen Children's Medical Center, Bayside, NY, United States; Jane Cerise, Northwell Health Office of Academic Affairs, New Hyde Park, NY, United States; Matthew D. Taylor, Cohen Children’s Medical Center, New Hyde Park, NY, United States; Kristina Murphy, Cohen Children’s Medical Center, New Hyde park, NY, United States

Background: A history of asthma has been shown to benefit adult patients presenting with sepsis; however, this association has not been thoroughly studied in the pediatric population. This investigation looked at whether or not this association exists in children under 18 years of age by examining duration of hospital stay and duration of antibiotic treatment in PICU patients presenting with sepsis. Our hypothesis is that pediatric patients with a history of asthma presenting with sepsis will have shorter duration of hospital stay and will require a shorter duration of antibiotic treatments.

Objective: The purpose of this study is to investigate an association between pediatric patients admitted to the PICU for treatment of sepsis and a personal history of asthma.

Design/Methods: This is a retrospective chart review of patients admitted to the hospital between Jan 2018 and Mar 2022 with a clinical concern for sepsis. A history of asthma, eczema, and food or seasonal allergies was recorded. Demographics, patient outcomes, and lab values were studied. Clinical sepsis concern was defined as a positive sepsis screen, use of sepsis order set or diagnostic code. This definition was further narrowed by antibiotic use during the hospital course.

Results: Six hundred sixty records of patients < 18 years old who received antibiotics were analyzed. Eighty-five patients (13%) had Type 2 disease or asthma (study group) and 575 did not (control group). One patient in the study group died (1%) compared to 23 (4%) in the control group. When analyzing in-hospital length of stay, total days on antibiotics, ventilator use, and vasoactive use, there were no statistical differences between subjects with Type 2 Disease or asthma and those with neither.

Conclusion(s): Patients with asthma and Type 2 disease admitted with an initial clinical concern for sepsis did not show increased survival compared to peers without those comorbidities. This study was performed with a convenient sample of patients who were screened with a broad definition of sepsis. Despite an attempt to narrow the sepsis criteria, a highly sensitive sepsis screen may have led to overtreatment of patients and skewed results. Further analysis may better define admission criteria for sepsis to differentiate patients with higher likelihood of serious bacterial infection.