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Predictors of Mortality in Paediatric Myocarditis
Shahla Abrar1, Mohammed Junaid Ansari2, Mahima Mittal3
1Senior Resident, Department of Paediatrics, B.R.D. Medical College , Gorakhpur, India .
Journal of Clinical and Diagnostic Research : JCDR
|August 10, 2016
Summary
Pediatric myocarditis mortality is predicted by NYHA class IV dyspnea, elevated Brain Natriuretic Peptide (BNP), and reduced ejection fraction. These factors independently indicate a worse outcome in children with this condition.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Biomarker Research
Background:
- Pediatric myocarditis presents with variable severity, from mild symptoms to life-threatening conditions.
- Early identification of severe cases is crucial, especially in resource-limited settings.
Purpose of the Study:
- To identify admission factors predicting mortality in pediatric myocarditis.
- To inform early intervention strategies for severe pediatric myocarditis.
Main Methods:
- Observational study of pediatric myocarditis patients (August 2014 - December 2015).
- Clinical features, cardiac biomarkers (Troponin I, BNP), and echocardiography were analyzed.
- Multivariate logistic regression identified independent predictors of mortality.
Main Results:
- Mortality rate was 17.7% (11/62).
- Non-survivors showed higher rates of NYHA class IV dyspnea, hypotension, elevated Troponin I, elevated BNP, and decreased LV ejection fraction.
- Multivariate analysis identified NYHA class IV dyspnea, BNP, and ejection fraction as independent predictors of mortality.
Conclusions:
- Hypotension, elevated Troponin I, elevated BNP, and decreased ejection fraction are associated with increased mortality in pediatric myocarditis.
- NYHA class IV dyspnea, higher BNP levels, and reduced ejection fraction are independently linked to adverse outcomes.
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