如不进行治疗,重症脓毒症的死亡率会超过 80%。[126]Friedman G, Silva E, Vincent JL. Has the mortality of septic shock changed with time? Crit Care Med. 1998 Dec;26(12):2078-86.http://www.ncbi.nlm.nih.gov/pubmed/9875924?tool=bestpractice.com 经过治疗,年满 19 岁儿童的总体死亡率接近 10%。[127]Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001 Jul;29(7):1303-10.http://www.ncbi.nlm.nih.gov/pubmed/11445675?tool=bestpractice.com 不同性别儿童的死亡率无差异。已有疾病患者的死亡率为 12.8%,高于既往健康患者的死亡率 (7.8%)。[128]Watson RS, Carcillo JA. Scope and epidemiology of pediatric sepsis. Pediatr Crit Care Med. 2005 May;6(3 suppl):S3-5.http://www.ncbi.nlm.nih.gov/pubmed/15857554?tool=bestpractice.com
在患癌症的儿童中,脓毒症的总体死亡率为 17%。在接受过造血干细胞移植的儿童中,该比率上升至 30%。在高危人群中,真菌性脓毒症具有显著更高的死亡率,为 63%。[129]Fiser RT, West NK, Bush AJ, et al. Outcome of severe sepsis in pediatric oncology patients. Pediatr Crit Care Med. 2005 Sep;6(5):531-6.http://www.ncbi.nlm.nih.gov/pubmed/16148811?tool=bestpractice.com
收入重症监护病房时,持续性休克与死亡比值比增加相关,比值比为 3.8 (95% CI: 1.4-10.2)。[130]Inwald DP, Tasker RC, Peters MJ, et al; Paediatric Intensive Care Society Study Group (PICS-SG). Emergency management of children with severe sepsis in the United Kingdom: the results of the Paediatric Intensive Care Society sepsis audit. Arch Dis Child. 2009 May;94(5):348-53.http://www.ncbi.nlm.nih.gov/pubmed/19131419?tool=bestpractice.com 每小时持续休克的死亡比值比为 2.29(95% CI 1.19 至 4.44)。[131]Han YY, Carcillo JA, Dragotta MA, et al. Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome. Pediatrics. 2003 Oct;112(4):793-9.http://www.ncbi.nlm.nih.gov/pubmed/14523168?tool=bestpractice.com
一项在波士顿儿童医院开展的研究发现,根据美国危重症医学学院儿科高级生命支持 (ACCM-PALS) 指南,在及早识别脓毒症和进行复苏的情况下,患者在重症监护病房入住的平均时长为 5.5 天,住院的平均时长为 8 天。[80]Paul R, Neuman MI, Monuteaux MC, et al. Adherence to PALS sepsis guidelines and hospital length of stay. Pediatrics. 2012 Aug;130(2):e273-80.http://pediatrics.aappublications.org/content/130/2/e273.longhttp://www.ncbi.nlm.nih.gov/pubmed/22753559?tool=bestpractice.com