ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Critical Care
Volume 13 - 2025 | doi: 10.3389/fped.2025.1588634
Analysis of the association between cholinesterase and in-hospital mortality in children with bloodstream infections in the pediatric intensive care unit
Provisionally accepted
- 1Shanghai Children's Medical Center, Shanghai, Shanghai Municipality, China
- 2Shanghai Tenth People's Hospital, Tongji University, Shanghai, Shanghai Municipality, China
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Objective: Our aim was to assess the relationship between BChE levels on admission to the intensive care unit and death from bloodstream infections in the PICU (paediatric intensive care unit). Methods: We conducted a retrospective analysis using the Paediatric Intensive Care Unit Database (a large Chinese paediatric intensive care database from 2010 to 2018) to assess BChE levels at the time of intensive care unit admission in 329 critically ill children with bloodstream infection admitted to the intensive care unit. We analysed the relationship between BChE and death from bloodstream infections. We used multifactor logistic analysis regression and adjusted smooth spline plots to estimate the relationship between BChE and death from bloodstream infections. Results: Of 329 children, 53 (16%) died in hospital. After correction for confounders, BChE was negatively associated with the risk of death in the PICU. For every 1,000 U/L increase in BChE, the risk of death was reduced by 16% (corrected OR = 0.84, 95% CI: 0.79, 0.89). After adjusting for confounders, the risk of death decreased by 23% for every 1,000 U/L increase in BChE(OR = 0.77, 95% CI: 0.63, 0.96). Patients with BChE levels between 5,000-8,000 U/L had a 51% lower risk of death, while those with BChE levels >8,000 U/L had a 77% lower risk of death, compared to those with BChE levels <5,000 U/L. Conclusion: According to multiple regression analysis, decreased BChE is an independent risk factor for all-cause mortality in children with bloodstream infections in pediatric intensive care units.
Keywords: BChE (butyrylcholinesterase enzyme), PICU (pediatric intensive care unit), Bloodstream infection (BSI), Children, database
Received: 06 Mar 2025; Accepted: 16 Jul 2025.
Copyright: © 2025 Ding, Sun and Zhong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qi Zhong, Shanghai Tenth People's Hospital, Tongji University, Shanghai, 200070, Shanghai Municipality, China
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