Comparison of two different severity scores (Paediatric Risk of Mortality [PRISM] and the Glasgow Meningococcal Sepsis Prognostic Score [GMSPS]) in meningococcal disease: preliminary analysis.
Two different illness severity scores, Pediatric Risk of Mortality (PRISM) and the Glasgow Meningococcal Sepsis Prognostic Score (GMSPS), were evaluated and compared in meningococcal disease in two paediatric intensive care units. Forty-nine children with a median age of 36 months who had meningococcal sepsis confirmed by laboratory data were evaluated. Overall mortality was 18%. The median GMSPS was 3 in survivors and 8 in non-survivors. A GMSPS > or = 8 was significantly associated with death (p = 0.0001) with a mortality predictivity and specificity of 70% and 92.5%, respectively. The median PRISM score in survivors was 5.5 and 23 in non-survivors. A PRISM score of > or = 11 was significantly related to death (p < 0.0001). The Kendal correlation co-efficient between GMSPS and PRISM showed tau = 0.6859 (p = 0.0000). It is concluded that GMSPS and PRISM are useful methods for identifying and classifying children into low and high risk categories. GMSPS > or = 8 or a PRISM score > or = 11 are significantly predictive of mortality.
Silva
P S
PS
Paediatric Intensive Care Unit, Department of Paediatrics, São Paulo Federal University and Emílio Ribas Infectious Disease Institute, São Paulo, Brazil. psls.nat@terra.com.br
Fonseca
M C
MC
Iglesias
S B
SB
Carvalho
W B
WB
Bussolan
R M
RM
Freitas
I W
IW
D000293:Adolescent; D016470:Bacteremia / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate