Laboratory and clinical variables to predict outcome in hemolytic-uremic syndrome.
To develop a guide to the prognosis of children with hemolytic-uremic syndrome, we reviewed the medical records of 78 patients with this diagnosis seen at The Children's Hospital, Boston, from 1976 through 1986. Two outcome groups were defined as follows: a "good outcome" group, which contained 6 patients with no serious sequelae at hospital discharge, and a "bad outcome" group, which contained 12 patients who died, had chronic renal failure, or had central nervous system sequelae at hospital discharge. Differences between the two groups in routine laboratory tests available within 48 hours of admission were identified by bivariate analysis. Using serum calcium (less than or equal to 2 mmol/L) plus urine output (less than 0.4 mL/kg/h) over a 24-hour period as a test to predict outcome, we identified patients who died, had chronic renal failure, or had serious central nervous system sequelae, with 75% sensitivity, 98% specificity, and 90% positive predictive value.
Department of Pediatrics, Children's Hospital, Boston.
P L
PL
Havens
P P
PP
O'Rourke
J
J
Hahn
J
J
Higgins
A M
AM
Walker
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology; D003955:Diagnostic Tests, Routine; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000209:etiology