Prognostic significance of clinical and laboratory parameters in pediatric intensive care sepsis: a retrospective cohort study

Aim: Sepsis is a major cause of morbidity and mortality among critically ill pediatric patients.Early identification of high-risk individuals through clinical and biochemical markers may improve patient outcomes.This study aimed to investigate the relationship between early clinical and laboratory parameters and mortality in children diagnosed with sepsis in a pediatric intensive care unit (PICU).Methods: This single-center, retrospective cohort study included 128 pediatric patients diagnosed with sepsis and admitted to the PICU of Gaziantep City Hospital between January 2024 and January 2025.Demographic, clinical, and laboratory data were recorded within the first 24 hours of admission.Survivors and non-survivors were compared, and logistic regression and ROC analyses were performed to identify independent predictors of mortality.Results: Of the 128 patients, 95 (74.2%) survived and 33 (25.8%) died.Non-survivors had significantly higher levels of lactate (4.30 ± 3.30 vs. 2.88 ± 2.23 mmol/L, p = 0.017), ferritin (940 ± 450 vs. 480 ± 320 ng/mL, p = 0.008), total and direct bilirubin, and lower bicarbonate and base excess levels (p < 0.05 for all).In multivariate logistic regression, lactate (OR = 1.21, p = 0.039), ferritin (OR = 1.20, p = 0.009), bicarbonate (OR = 2.16, p = 0.011), and base excess (OR = 0.51, p = 0.006) were identified as independent predictors of mortality.ROC analysis demonstrated acceptable discriminative ability for all four parameters (AUC range: 0.659-0.740).Conclusion: Elevated lactate and ferritin levels and decreased bicarbonate and base excess values were independently associated with mortality in pediatric sepsis.These commonly available biomarkers may provide valuable prognostic insight and help guide early clinical decision-making in the intensive care setting.