ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Critical Care
Volume 13 - 2025 | doi: 10.3389/fped.2025.1661086
This article is part of the Research TopicAdvancing pediatric critical care: Sepsis, immune dysregulation, and precision therapiesView all 4 articles
Risk Factors for Mortality and Development of a Predictive Model in Pediatric Sepsis
Provisionally accepted
- Second Hospital of Hebei Medical University, Shijiazhuang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To investigate the clinical characteristics and risk factors associated with mortality in pediatric sepsis patients, and to establish a predictive model for early identification of high-risk children. Methods: A retrospective cohort study was conducted including 143 pediatric sepsis cases admitted to the Pediatric Intensive Care Unit of the Second Hospital of Hebei Medical University from January 2020 to December 2024. Clinical data, laboratory indicators, and treatment history were collected. Univariate and multivariate logistic regression analyses were performed to identify risk factors for mortality. A nomogram model was constructed based on significant predictors, and its predictive performance was evaluated by receiver operating characteristic (ROC) curve analysis. Results: Among the 143 cases, 121 survived and 22 died. Significant differences were observed between the survival and death groups in lymphocyte count, platelet count, albumin, D-dimer, liver function tests (ALT, TBIL), CALLY index, and pre-admission glucocorticoid use (P < 0.05). Multivariate analysis identified platelet count (OR = 0.992, 95% CI: 0.987-0.997), D-dimer (OR = 7.571, 95% CI: 2.642-21.698), and CALLY index (OR = 0.532, 95% CI: 0.323-0.877) as independent risk factors for mortality. The nomogram model incorporating these factors showed good predictive accuracy with an area under the ROC curve of 0.859 (95% CI = 0.742–0.953). Conclusion: Platelet count, D-dimer level, and CALLY index are valuable indicators for assessing prognosis in pediatric sepsis and can aid in early risk stratification. The established nomogram provides a useful tool for clinical decision-making to improve outcomes in high-risk pediatric sepsis patients. Further multicenter prospective studies are warranted to validate and refine these findings.
Keywords: Children, Sepsis, Mortality risk factors, CALLY index, albumin
Received: 07 Jul 2025; Accepted: 27 Aug 2025.
Copyright: © 2025 Wang, Feng, Yang, Wang and Chen. 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: Yuan Chen, Second Hospital of Hebei Medical University, Shijiazhuang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.