A new prognostic scoring system for meningococcal septic shock in children. Comparison with three other scoring systems

Castellanos-Ortega, Álvaro; Delgado-Rodrı́guez, Miguel; Llorca, Javier; Buron, Pilar Sanchez; Bartolomé, S. Mencía; Rubio, J. A. Soult; Manso, G. Milano; Domínguez-Sampedro, P.; Montero, Ramiro Blanco; Núñez, Antonio Rodríguez; Perez, Elisa Zambrano; Galán, Corsino Rey; Negueruela, Nuria Lopez; Sáenz, R. Reig

doi:10.1007/s00134-001-1196-z

Cited by 33 publications

(20 citation statements)

References 33 publications

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“…Requirement of mechanical ventilation was an independent risk factor for mortality in two studies. 12,13 Requirement of multiple inotropes was associated with poor outcome. In a study done by Delgado, et al requirement of inotropes especially multiple inotropes was associated with poor outcome.…”

Section: Resultsmentioning

confidence: 99%

Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India

Vasundhara¹,

Sahoo²,

Chowdary³

2017

Int J Contemp Pediatr

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Background: Shock is a state of impaired tissue perfusion resulting in an imbalance between oxygen demand and supply. This widespread reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients, the end result of which is an altered cellular and sub cellular function leading to anaerobic metabolism and accumulation of lactic acid, and consequently cellular damage, multiple organ dysfunction and finally cardiovascular collapse.Methods: The present study was conducted in the department of Pediatrics at Alluri Sitarama Raju Academy of Medical Sciences hospital, Eluru, between December 2014 and June 2016. It is a prospective study. Children aged 1 month to 12 years with a clinical diagnosis of shock were included after written consent from parents.Results: Out of 75 children admitted with shock, 69.33% had septic shock, 25.33% had hypovolemic shock, 2.66% had distributive shock, 2.66% cardiogenic shock. Most common age group admitted with shock was 1 month-1 year 38.666%. Among 75 children with shock, 74.66% children survived and 25.33% children died. Mortality rate in cardiogenic shock was 100%, in septic shock 28.84%, in hypovolemic shock 10.52%.Conclusions: Septic shock was the most common type of shock. Most common cause for septic shock was pneumonia. Septic shock has got highest mortality in the present study.Need for inotropes and mechanical ventilaton indicates poor prognosis in shock.

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Section: Resultsmentioning

confidence: 99%

Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India

Vasundhara¹,

Sahoo²,

Chowdary³

2017

Int J Contemp Pediatr

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“…Até o momento, estudos independentes não utilizaram grupos de pacientes heterogênicos próprios da UTIP, mas algumas categorias específicas de doença 11,16,21 , novas versões do método 10 ou grupos de pacientes homogêneos de alta mortalidade 22 . Nenhum estudo nesse sentido foi publicado na América Latina.…”

Section: Introductionunclassified

Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Martha¹,

García²,

Piva³

et al. 2005

J Pediatr (Rio J)

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Resultados: Internaram na unidade de terapia intensiva pediátri-ca 498 pacientes, sendo 77 excluídos. Dos 421 pacientes estudados, 33 (7,83%) foram a óbito. A mortalidade estimada pelo PRISM foi de 30,84 (7,22%), com standardized mortality rate 1,07 (0,74-1,50), z = -0,45. Pelo PIM, foi de 26,13 (6,21%), com standardized mortality rate 1,26 (0,87-1,77), z = -1,14. O teste de ajuste de Hosmer-Lemeshow obteve um qui-quadrado 9,23 (p = 0,100) para o PRISM e 27,986 (p < 0,001) para o PIM. A área abaixo da curva ROC foi 0,870 (0,810-0,930) para o PRISM e 0,845 (0,769-0,920) para o PIM. Teste de Spearman r = 0,65 (p < 0,001).Conclusão: Na análise dos testes podemos constatar que, embora o PIM apresente uma pior calibração no conjunto dos resultados, tanto o PRISM como o PIM apresentaram boa capacidade de discriminar entre sobreviventes e não sobreviventes, constituindo-se em ferramentas de desempenho comparáveis na avaliação prognóstica de pacientes pediá-tricos admitidos em nossa unidade. AbstractObjective: To compare the performance of the PRISM (Pediatric Risk of Mortality) and the PIM (Pediatric Index of Mortality) scores at a general pediatric intensive care unit, investigating the relation between observed mortality and survival and predicted mortality and survival.Methods: A contemporary cohort study undertaken between 1 June 1999 and 31 May 2000 at the Pontifícia Universidade Católica do Rio Grande do Sul, Hospital São Lucas pediatric intensive care unit. The inclusion criteria and the PRISM and PIM calculations were performed as set out in the original articles and using the formulae as published. Statistical analysis for model evaluation employed the Flora z test, Hosmer-Lemeshow goodness-of-fit test, ROC curve (receiver operating characteristic) and Spearmans correlation tests. The study was approved by the institutions Ethics CommitteeResults: Four hundred and ninety-eight patients were admitted to the pediatric intensive care unit, 77 of whom presented exclusion criteria. Thirty-three (7.83%) of the 421 patients studied died and 388 patients were discharged. Estimated mortality by PRISM was 30.84 (7.22%) with a standardized mortality rate of 1.07 (0.74-1.50), z = -0.45 and by PIM this was 26.13 (6.21%) with a standardized mortality rate of 1.26 (0.87-1.77), z = -1.14. The Hosmer-Lemeshow test gave a chi-square of 9.23 (p = 0.100) for PRISM and 27.986 (p < 0.001) for PIM. The area under the ROC curve was 0.870 (0.810-0.930) for PRISM and 0.845 (0.769-0.920) for PIM. The Spearman test returned r = 0.65 (p < 0.001).Conclusion: Analyzing the tests we can observe that, although the PIM test was less well calibrated overall, both PRISM and PIM offer a good capacity for discriminating between survivors and moribund patients. They are tools with comparable performance at the prognostic evaluation of the pediatric patients admitted to our unit.

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“…Dengan kalibrasi yang baik, apabila besaran skor menunjukkan risiko kematian 20% pada 100 orang, kita seharusnya dapat memprediksi 20 dari 100 orang tersebut akan meninggal. 5 Karena tidak mengukur risiko dalam skala kontinu, PELOD harian merupakan instrumen yang sulit dikalibrasi seperti yang diterapkan oleh sistem skor lainnya. Pediatric Logistic Organ Dysfunction harian menggunakan skor komposit dengan koefisien tunggal.…”

Section: Metodeunclassified

Penggunaan Skor Pediatric Logistic Organ Dysfunction Harian sebagai Prediktor Mortalitas Anak yang Dirawat di Unit Perawatan Intensif Anak

Salim

Suparyatha

Nym

2016

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Latar belakang. Penggunaan sistem skoring Pediatric Logistic Organ Dysfunction (PELOD) sebagai prediktor mortalitas anak yang dirawat di Unit Perawatan Intensif Anak (UPIA) di Indonesia masih belum banyak diteliti.Tujuan. Mengetahui hubungan skor PELOD harian dalam memprediksi mortalitas anak yang dirawat di UPIA.Metode. Penelitian observasional analitik terhadap 49 anak yang dirawat di UPIA bulan Maret-Juli 2012. Skor PELOD harian dinilai selama satu minggu pertama perawatan dan dibandingkan antara subyek hidup dan meninggal. Analisis statistik dikerjakan dengan menggunakan program komputer.Hasil. Terdapat perbedaan nilai skor PELOD harian rendah, sedang, dan tinggi terhadap mortalitas anak yang dirawat di UPIA pada perawatan hari ketiga dengan p=0,001. Nilai skor sedang dan tinggi masing-masing berhubungan dengan peningkatan risiko mortalitas dengan RR 2,3 (1,09-5,02) dan RR 3,3 (1,01-10,6). Rerata terjadinya mortalitas menurut analisis kurva Kapplan Meier pada skor rendah, sedang, dan tinggi masing-masing 23, 12 dan 7 hari dengan p=0,002.Kesimpulan. Skor PELOD harian dapat memprediksi mortalitas anak yang dirawat di UPIA dengan prediksi terbaik pada hari ketiga.

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A new prognostic scoring system for meningococcal septic shock in children. Comparison with three other scoring systems

Abstract: A new prognostic score is proposed for therapeutic stratification of children with presumed meningococcal septic shock.

Cited by 33 publications

References 33 publications

Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India

Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India

Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Penggunaan Skor Pediatric Logistic Organ Dysfunction Harian sebagai Prediktor Mortalitas Anak yang Dirawat di Unit Perawatan Intensif Anak

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