Risk factors for chronic critical illness in children with sepsis

Introduction . Sepsis is a severe life-threatening disease associated with high mortality and long-term decrease in the quality of life of surviving patients. The objective was to identify risk factors associated with the development of chronic critical illness (CCI) in children with sepsis. Materials and methods . A retrospective analysis of children with sepsis admitted to the intensive care unit (ICU) of the Republican Children’s Clinical Hospital from January 2020 to June 2025 was performed. Patients were divided into two groups based on clinical outcomes: the CCI group, defined by an ICU stay of ≥14 days with persistent organ dysfunction, and the non-CCI group, including patients with rapid recovery or early death. Data on baseline demographics, clinical characteristics, and diagnostic and therapeutic differences were collected and analyzed. Results . Of 326 children with sepsis, 44 were classified as CCI (13.5%) and 282 as non-CCI (86.5%), including 31 deaths and 251 rapid recovery. No significant differences were observed between the groups by gender or age. Respiratory diseases were the predominant sources of infection in both groups. Compared with the group without CCI, children with CCI had a longer duration of mechanical ventilation, a higher frequency of infections caused by carbapenem-resistant pathogens, higher baseline pSOFA scores, and comorbidity. ROC analysis identified prolonged mechanical ventilation, carbapenem resistance, and pSOFA score as independent risk factors for the development of CCI in children with sepsis. Conclusion . Risk factors for the development of CCI in pediatric sepsis include prolonged mechanical ventilation, multidrug resistance of infectious agents, and elevated pSOFA scores.