Evaluation of scoring systems in acute meningococcaemia

Area of Science:

• Pediatrics
• Infectious Diseases
• Critical Care Medicine

Background:

• Acute meningococcal infections can lead to life-threatening complications requiring prompt recognition and monitoring.
• Several prognostic scoring systems exist to aid in predicting outcomes for patients with meningococcal disease.

Purpose of the Study:

• To compare the bedside availability and prognostic significance of three scoring systems: Glasgow meningococcal sepsis prognostic score (GMSPS), Neisseria sepsis index (NESI), and Algren criteria.
• To evaluate the accuracy of these scoring systems in predicting outcomes in pediatric patients with meningococcemia.

Main Methods:

• Retrospective analysis of 20 consecutive pediatric patients with proven meningococcal infection admitted to a pediatric intensive care unit.
• Calculation and evaluation of GMSPS, NESI, and Algren criteria based on clinical and biological data collected upon admission.

Main Results:

• All three scoring systems predicted death in the four non-surviving patients.
• The Algren criteria demonstrated higher accuracy in predicting clinical severity compared to GMSPS and NESI.
• GMSPS, NESI, and Algren criteria falsely predicted death in 6, 5, and 1 patient(s), respectively.

Conclusions:

• While the Algren criteria showed better predictive accuracy, caution is advised when making critical therapeutic or ethical decisions based solely on these scoring systems due to their limitations in precision.
• These scoring systems may assist in decision-making regarding patient transfer, intensive care monitoring, and consideration of novel therapies for meningococcal infections.