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Prognostic score in acute meningococcemia.

J I Emparanza1, L Aldamiz-Echevarria, E G Perez-Yarza

  • 1Pediatric Intensive Care Unit, Ntra. Sra. de Aranzazu Children's Hospital, San Sebastian, Spain.

Critical Care Medicine
|February 1, 1988
PubMed
Summary

A new prognostic score helps predict outcomes for children with acute meningococcemia, a serious infection. This score accurately identifies children likely to survive or die from this critical illness.

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute meningococcemia is a life-threatening bacterial infection in children.
  • Predicting outcomes in pediatric patients with meningococcemia is crucial for timely intervention.
  • Existing methods for outcome prediction may lack sufficient accuracy.

Purpose of the Study:

  • To develop and validate a novel prognostic score for children diagnosed with acute meningococcemia.
  • To identify key clinical and laboratory variables that predict survival and mortality in this patient population.

Main Methods:

  • A retrospective review of 176 pediatric patients with acute meningococcemia admitted to a pediatric intensive care unit over three years.
  • Stepwise linear discriminant analysis was employed to identify significant predictors from 18 admission variables.

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  • The developed score was evaluated for its predictive accuracy for survival and death.

    • Main Results:

    • Nine variables demonstrated significant discriminant power: coma, base excess, platelets, glucose, temperature, white blood cell count (WBC), sex, purpura, and cerebrospinal fluid (CSF) findings.
    • The prognostic score achieved 100% accuracy in predicting survival and 91% accuracy in predicting death.
    • The predictive performance of the new score surpassed that of traditional clinical and laboratory variable frequency evaluations.

    Conclusions:

    • A validated prognostic score can accurately predict survival and mortality in children with acute meningococcemia.
    • The identified nine variables provide a robust basis for assessing prognosis in critically ill children with this infection.
    • This score offers a valuable tool for clinicians in managing pediatric acute meningococcemia.