Meningococcal septic shock in children: Clinical and laboratory features, outcome, and development of a prognostic score

被引:53
作者
Kornelisse, RF
Hazelzet, JA
Hop, WCJ
Spanjaard, L
Suur, MH
vanderVoort, E
deGroot, R
机构
[1] UNIV ROTTERDAM HOSP, DEPT PEDIAT, DIV PEDIAT INFECT DIS & IMMUNOL, SOPHIA CHILDRENS HOSP, NL-3015 GJ ROTTERDAM, NETHERLANDS
[2] UNIV ROTTERDAM HOSP, DEPT PEDIAT, DIV PEDIAT INTENS CARE, SOPHIA CHILDRENS HOSP, NL-3015 GJ ROTTERDAM, NETHERLANDS
[3] ERASMUS UNIV ROTTERDAM, DEPT EPIDEMIOL & BIOSTAT, NL-3000 DR ROTTERDAM, NETHERLANDS
[4] UNIV AMSTERDAM, NETHERLANDS REFERENCE LAB BACTERIAL MENINGITIS, NATL INST PUBL HLTH & ENVIRONM, AMSTERDAM, NETHERLANDS
关键词
D O I
10.1086/513759
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
The clinical characteristics of and outcome for 75 children with meningococcal septic shock were studied. in addition, a new prognostic scoring system was developed. The median age of the patients was 3.2 years (range, 3 weeks to 17.9 pears). The most common phenotype of Neisseria meningitidis was B:4:P1.4 (27%). A mortality rate of 21% was observed. Ten (17%) of the 59 survivors had serious sequelae. Calcium levels were significantly lower in patients with seizures. Disseminated intravascular coagulation occurred in 58% of the patients who were tested. Logistic regression analysis identified four laboratory features independently associated with mortality: serum C-reactive protein level, base excess, serum potassium level, and platelet count, These features were used to develop a novel scoring system with a predictive value for death and survival of 71% and 90%, respectively, The outcome was predicted correctly for 86% of the patients, which is higher than rates previously reported for scoring systems.
引用
收藏
页码:640 / 646
页数:7
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