The product of platelet and neutrophil counts (PN product) at presentation as a predictor of outcome in children with meningococcal disease.
BACKGROUND
Despite improvement in the treatment of Neisseria meningitidis infection, meningococcal diseases (MD) are still an important cause of morbidity and mortality around the world. This study assessed the performance of the product of platelet and neutrophil counts (PN product) at the time of presentation to hospital as a predictor of outcome in children with MD.


METHODS
Retrospective evaluation of children with clinical MD admitted to two paediatric intensive care units in Brazil.


RESULTS
Seventy-two children aged 2-156 months were studied. Overall mortality was 19.7%. The PN product, the Glasgow Meningococcal Septicaemia Prognostic Score and the Paediatric Risk of Mortality score discriminated between survivors and non-survivors. A PN < or = 113 had a sensitivity of 28.6% (95% CI 8.6-58.1), specificity of 96.6% (95% CI 88.1-99.5) and positive and negative predictive values of 66.7% and 84.8%. The area under the receiver operating characteristic curve was 0.85 (95% CI 0.74-0.92).


CONCLUSIONS
The PN product had a lower performance than reported in previous studies from a developed country. The PN product, however, is a good indicator of mortality in MD but needs to be validated for the population to which it is being applied.
Silva
Paulo Sérgio Lucas
PS
Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal de São Paulo, Brazil. psls.nat@terra.com.br
Iglesias
Simone Brasil Oliveira
SB
Nakakura
Cesar Hiroyuki
CH
de Aguiar
Vâania Euzébio
VE
de Carvalho
Werther Brunow
WB
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D008589:Meningococcal Infections / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D009504:Neutrophils / Q000473:pathology; D010976:Platelet Count; D011379:Prognosis; D012720:Severity of Illness Index