Background: Sepsis is a major cause of illness and mortality. Children in pediatric intensive care units (PICU) in developed nations experience a sepsis mortality rate that exceeds 50%. For efficient patient care, evaluating disease severity at admission is critical for prognosis, management, and optimal use of resources.

Aim of the study: To assess the prognostic value of serum apolipoprotein A-V levels in children with sepsis admitted to the PICU.

Patients and methods: This study was conducted in the PICU in collaboration with the clinical pathology department of Zagazig University Hospital, on patients aged between 28 days and 16 years who were admitted with sepsis. We evaluated patients with complete sepsis screening and serum apolipoprotein A-V levels.

Results: The mean age of the studied group was 46±55.6 months. More than half of the study group had associated comorbidities and congenital heart disease was most common, followed by renal disease, and neurologic disorders. Acinetobacter baumannii complex, coagulase-negative Staphylococcus, and Klebsiella pneumoniae were the most prevalent pathogens affecting previously healthy children. In contrast, pseudomonas aeruginosa and Staphylococcus aureus were the most prevalent pathogens in children with comorbidities. Half of patients were survivors. An apolipoprotein A-V level of 89.5 ng/ml predicted mortality due to sepsis with 73.4% sensitivity, 52.7% accuracy, and 32.1% specificity.

Conclusion: Serum apolipoprotein A-V levels are sensitive in predicting sepsis-related mortality in the PICU for early therapy within the first few hours after sepsis presentation, which can prevent predictable progression and poor outcomes such as organ failure and death.