A new prognostic scoring system for meningococcal septic shock in children. Comparison with three other scoring systems
| Autor: | Corsino Rey Galán, Antonio Rodríguez Núñez, Javier Llorca, Álvaro Castellanos-Ortega, Nuria Lopez Negueruela, Roberto Reig Saenz, Elisa Zambrano Perez, Guillermo Milano Manso, Miguel Delgado-Rodríguez, Santiago Mencia Bartolome, Pedro Dominguez Sampedro, Juan Antonio Soult Rubio, Pilar Sanchez Buron, Ramiro Blanco Montero |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Meningitis Meningococcal Critical Care and Intensive Care Medicine Logistic regression Meningococcal disease Intensive Care Units Pediatric law.invention law Internal medicine Intensive care medicine Humans Multicenter Studies as Topic Glasgow Coma Scale Child Retrospective Studies Pediatric intensive care unit Septic shock business.industry Hemodynamics Infant Retrospective cohort study medicine.disease Prognosis Intensive care unit Shock Septic Survival Rate Logistic Models Child Preschool Female business |
| Zdroj: | Intensive care medicine. 28(3) |
| ISSN: | 0342-4642 |
| Popis: | Objective: To develop a quick and sensitive method for identification of children with presumed meningococcal septic shock at risk of death at admission to the pediatric intensive care unit (PICU) and to compare its performance with three other prognostic systems: Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS), Malley score and the Paediatric Index of Mortality (PIM). Design: Multicenter retrospective cohort study. Setting: PICUs of 14 tertiary hospitals. Patients: The developmental sample included 192 children consecutively admitted to the PICUs with presumed or confirmed meningococcal septic shock from 1983 to 1995. The validation sample included 158 children consecutively admitted from 1996 to 1998. Interventions: Clinical and laboratory data gathered during the first 2 h after admission were used to develop the new score and to compute the other scoring systems. Logistic regression was applied to identify the independent predictors of death. Measurements and results: Overall mortality was 31.5%. The new score included seven variables: cyanosis (2 points), Glasgow coma scale less than 8 (2 points), refractory hypotension (2 points), oliguria (1 point), leukocytes less than 4000/mm3 (1 point), partial thromboplastin time more than 150% of control value (1 point) and base deficit more than 10 mmol/l (1 point). The new score provided the best discriminative capability, as measured by the area under the ROC curve (SEM) in the validation sample =0.88 (0.03), PIM =0.82 (0.04), Malley I =0.80 (0.04), GMSPS =0.79 (0.04) and Malley II =0.76 (0.04). Conclusions: A new prognostic score is proposed for therapeutic stratification of children with presumed meningococcal septic shock. |
| Databáze: | OpenAIRE |
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