title: The product of platelet and neutrophil counts (PN product) at presentation as a predictor of outcome in children with meningococcal disease.
abstract: 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.
authors.affiliation: Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal de São Paulo, Brazil. psls.nat@terra.com.br
authors.forename: Paulo Sérgio Lucas
authors.initials: PS
authors.lastname: Silva
authors.forename: Simone Brasil Oliveira
authors.initials: SB
authors.lastname: Iglesias
authors.forename: Cesar Hiroyuki
authors.initials: CH
authors.lastname: Nakakura
authors.forename: Vâania Euzébio
authors.initials: VE
authors.lastname: de Aguiar
authors.forename: Werther Brunow
authors.initials: WB
authors.lastname: de Carvalho
mesh_terms: 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