Multivariable predictive models for adverse outcome of invasive meningococcal disease in children☆,☆☆,★
Section snippets
Population
After institutional approval, we reviewed the medical records of all patients younger than 20 years of age who were admitted to Harbor-University of California at Los Angeles Medical Center, Torrance, and to Children's Hospital, Boston, Mass., with a diagnosis of IMD between January 1985 and October 1990. Cases were identified through bacteriology laboratory records and discharge diagnoses of all patients admitted to these two hospitals during this period. These patients constituted the
Patient characteristics (Table I)
DISCUSSION
We derived and validated two models for the prediction of adverse outcome of IMD in children. The first model included clinical data (perfusion status) and data from a complete blood cell count (ANC, platelet count). These data are readily and almost universally available to the clinician at the time of the initial encounter with the patient. The second model included data from a complete blood cell count (ANC) and the serum fibrinogen concentration. These models should be easy to use because
Acknowledgements
We thank Kathleen Harney, MD, and Nicole Glaser, MD, for their critical review of the manuscript.
References (33)
- et al.
Treatment of purpura fulminans in meningococcemia with protein C concentrate
J Pediatr
(1995) - et al.
Factors in the prognosis of meningococcal infection: review of 63 cases with emphasis on recognition and management of the severely ill patient
J Pediatr
(1966) - et al.
Laboratory-based surveillance for meningococcal disease in selected areas, United States, 1989-1991
MMWR CDC Surveill Summ
(1993) - et al.
Serogroup C meningococcal outbreaks in the United States: an emerging threat
JAMA
(1995) - et al.
Trends in mortality in children hospitalized with meningococcal infections, 1957 to 1987
Pediatr Infect Dis
(1989) - et al.
Meningococcal infections in children: a review of 100 cases
Pediatr Infect Dis
(1989) - et al.
An outbreak of meningococcal disease in Auckland, New Zealand
Pediatr Infect Dis
(1989) - et al.
Meningococcal infections in the Province of Quebec, Canada, during the period 1991 to 1992
J Clin Microbiol
(1995) - et al.
Surgical intervention for the complications of meningococcal-induced purpura fulminans
Pediatr Infect Dis
(1994) - et al.
Meningococcemia and purpura fulminans in adults: acute deficiencies of proteins C and S and early treatment with antithrombin III concentrates
Intensive Care Med
(1990)
Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin: a randomized, double-blind, placebo-controlled trial: the HA-1A Sepsis Study Group
N Engl J Med
Treatment of septic shock with human monoclonal antibody HA-1A: a randomized, double-blind, placebo-controlled trial: CHESS Trial Study Group
Ann Intern Med
The French National Registry of HA-1A (Centoxin) in septic shock: a cohort study of 600 patients: the National Committee for the Evaluation of Centoxin
Arch Intern Med
A controlled clinical trial of E5 murine monoclonal IgM antibody to endotoxin in the treatment of gram-negative sepsis: the XOMA Sepsis Study Group
JAMA
Influence of an anti-tumor necrosis factor monoclonal antibody on cytokine levels in patients with sepsis: the CB0006 Sepsis Syndrome Study Group
Crit Care Med
Initial evaluation of human recombinant interleukin-1 receptor antagonist in the treatment of sepsis syndrome: a randomized, open-label, placebo-controlled multicenter trial: the IL-1RA Sepsis Syndrome Study Group
Crit Care Med
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From the Divisions of Emergency Medicine and Infectious Diseases, Department of Medicine, Children's Hospital and Harvard Medical School, Boston, Massachusetts, and the Division of Emergency Medicine and Department of Pediatrics, University of California, Davis, School of Medicine
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Reprint requests: Richard Malley, MD, Division of Emergency Medicine, Children's Hospital, 300 Longwood Ave., Boston, MA 02115.
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0022-3476/96/$5.00 + 0 9/21/75816