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Mortality in severe meningococcal disease
K Thorburn1, P Baines, A Thomson
1Paediatric Intensive Care Unit, Royal Liverpool Children's Hospital-Alder Hey, Eaton Road, Liverpool L12 2AP, UK. kent.thorburn@rlch-tr.nwest.nhs.uk
Insights
Critically ill children with meningococcal disease have a lower mortality rate now. This study shows improved outcomes in pediatric intensive care units (PICUs) for this serious infection.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Epidemiology
Background:
- Meningococcal disease remains a significant cause of critical illness in children.
- Assessing mortality trends in pediatric intensive care units (PICUs) is crucial for evaluating treatment efficacy.
Purpose of the Study:
- To evaluate the mortality rate of critically ill children admitted with meningococcal disease.
- To compare current mortality data with historical studies.
Main Methods:
- A prospective study was conducted on children admitted to a regional PICU between January 1995 and March 1998 with meningococcal disease.
- Outcome measures included actual overall mortality, predicted mortality using the Pediatric Risk of Mortality (PRISM) score, and standardized mortality ratio (SMR).
Main Results:
- A total of 123 children were admitted; 11 (8.9%) died in the PICU.
- The predicted mortality by PRISM was 24.9, with an observed SMR of 0.44.
- Compared to four previous studies, the overall PICU mortality and SMR were lower.
Conclusions:
- Mortality for critically ill children with meningococcal disease has decreased.
- This improvement is observed even when accounting for disease severity, suggesting advancements in care.
Aim:
To evaluate mortality of critically ill children admitted with meningococcal disease.
Methods:
Prospective study of all children admitted to a regional paediatric intensive care unit (PICU) between January 1995 and March 1998 with meningococcal disease. Outcome measures were actual overall mortality, predicted mortality (by PRISM), and standardised mortality ratio.
Results:
A total of 123 children were admitted with meningococcal disease. There was an overall PICU mortality of 11 children (8.9%). The total mortality predicted by PRISM was 24.9. The standardised mortality ratio (SMR) was 0.44. Results were compared with those from four previously published meningococcal PICU studies (USA, Australia, UK, Netherlands) in which PRISM scores were calculated. The overall PICU mortality and SMR were lower than those in the previously published studies.
Conclusion:
Compared with older studies and calibrating for disease severity, this study found a decrease in the mortality of critically ill children with meningococcal disease.