Prognosis

Without treatment, sepsis carries a mortality rate in excess of 80%.[158] With treatment, overall mortality is approximately 10% in children up to the age of 19 years.[159] There is no sex difference in children. Patients with pre-existing disease experience a higher mortality rate of 12.8% compared with 7.8% in previously healthy children.[160]

In children with cancer, overall mortality from sepsis is 17%. The rate increases to 30% in children who have undergone haematopoietic stem cell transplants. Fungal sepsis carries a disproportionate mortality rate of 63% in this high-risk group.[161]

Persistent shock on admission to intensive care is associated with an increased odds ratio for death of 3.8 (95% CI 1.4 to 10.2).[162] Each additional hour of persistent shock is associated with a >2-fold increased odds of mortality.[163]

One US study at Boston Children's Hospital found that with early recognition of sepsis and resuscitation, according to the American College of Critical Care Medicine-Pediatric Advanced Life Support (ACCM-PALS) guidelines, the mean length of stay in the intensive care unit was 5.5 days and the mean length of stay in hospital was 8 days.[96]

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