(1551) Association Between Asthma & Prognosis of Critically Ill Pediatric Patients With Concern for Sepsis

Introduction: Adult studies show that asthma is associated with a better prognosis in critically ill patients with sepsis. We set out to investigate if an association exists between asthma and other Type 2 diseases (eczema and allergies) and outcomes of pediatric patients with clinical concern for sepsis.

Methods: This is a retrospective chart review of patients admitted to the hospital between Jan 2018 and Mar 2022 with a clinical concern for sepsis. A history of asthma, eczema, and food or seasonal allergies was recorded. Demographics, patient outcomes, and lab values were studied. Clinical sepsis concern was defined as a positive sepsis screen, use of sepsis order set or diagnostic code. This definition was further narrowed by antibiotic use during the hospital course.

Results: 660 records of patients < 18 years old who received antibiotics were analyzed. 85 patients (13%) had type 2 disease or asthma (study group) and 575 did not (control group). One patient in the study group died (1%) vs 23 (4%) in the control group. When analyzing in-hospital length of stay, total days on antibiotics, ventilator use, and vasoactive use, there were no statistical differences between subjects with Type 2 Disease or Asthma and those with neither.

Conclusions: Patients with asthma and type 2 disease admitted with an initial clinical concern for sepsis did not show increased survival compared to peers without those comorbidities. This study was performed with a convenient sample of patients who were screened with a broad definition of sepsis. Despite an attempt to narrow the sepsis criteria, a highly sensitive sepsis screen may have led to overtreatment of patients and skewed results. Further analysis may better define admission criteria for sepsis to differentiate patients with higher likelihood of serious bacterial infection.