title: Predictors of Mortality in Mechanically Ventilated Critical Pertussis in a low Income Country.
abstract: BACKGROUND
  Critical pertussis is characterized by severe respiratory failure, important leukocytosis, pulmonary hypertension, septic shock and encephalopathy.
  
  
  OBJECTIVE
  To describe the clinical course of critical pertussis, and identify predictors of death at the time of presentation for medical care.
  
  
  METHODS
  Retrospective study conducted in children's hospital Tunisian PICU between 01 January and 31 October 2013. Patients with critical pertussis confirmed by RT-PCR and requiring mechanical ventilation were included. Predictors of death were studied.
  
  
  RESULTS
  A total of 17 patients was studied. Median age was 50 days. Mortality was 23%. Predictors risk of mortality were : high PRISM score (Pediatric Risk of Mortality Score) (p=0,007), shock (p=0,002), tachycardia (p=0,005), seizures (p=0,006), altered mental status (p=0,006), elevated WBC count (p=0,003) and hemodynamic support (p=0022). However, the difference did not reach statistical significance in comorbidity, pneumoniae, high pulmonary hypertension or exchange transfusion. Concomitant viral or bacterial co-infection was not related to poor outcome.
  
  
  CONCLUSIONS
  Young infants are at high risk to have critical pertussis. Despite advances in life support and the treatment of organ failure in childhood critical illness, critical pertussis remains difficult to treat.
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Aida
authors.initials: A
authors.lastname: Borgi
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Khaled
authors.initials: K
authors.lastname: Menif
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Sarra
authors.initials: S
authors.lastname: Belhadj
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Narjess
authors.initials: N
authors.lastname: Ghali
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Loukil
authors.initials: L
authors.lastname: Salmen
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Asma
authors.initials: A
authors.lastname: Hamdi
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Ammar
authors.initials: A
authors.lastname: Khaldi
authors.affiliation: Microbiology laboratory, children's hospital Bechir Hamza of Tunis.
authors.forename: Aida
authors.initials: A
authors.lastname: Bouaffsoun
authors.affiliation: Group of Bioinformatics and Mathematical Modeling, Institute Pasteur of Tunis.
authors.forename: Sonia
authors.initials: S
authors.lastname: Kechaou
authors.affiliation: Microbiology laboratory, children's hospital Bechir Hamza of Tunis.
authors.forename: Amel
authors.initials: A
authors.lastname: Kechrid
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Asma
authors.initials: A
authors.lastname: Bouziri
authors.affiliation: Pediatric intensive care unit, children's hospital Bechir Hamza of Tunis.
authors.forename: Nejla
authors.initials: N
authors.lastname: Benjaballah