title: Invasive Meningococcal Disease: Application of Base Excess and Platelets Score in a Portuguese Paediatric Intensive Care Unit.
abstract: BACKGROUND
  Meningococcal infection has a high mortality and morbidity. Recently a new prognostic scoring system was developed for paediatric invasive meningococcal disease, based on platelet count and base excess â base excess and platelets score. The main objective of this study was to evaluate the accuracy of base excess and platelets score to predict mortality in children admitted to intensive care due to invasive meningococcal disease.
  
  
  METHODS
  Observational study, with retrospective data collection, during a 13.5 years period (01/2000 to 06/2013). Mortality by invasive meningococcal disease and related factors (organ dysfunction and multi-organ failure) were analysed. The base excess and platelets score was calculated retrospectively, to evaluate its accuracy in predicting mortality and compared with Paediatric Risk of Mortality and Paediatric Index of Mortality2.
  
  
  RESULTS
  Were admitted 76 children with invasive meningococcal disease. The most frequent type of dysfunction was cardiovascular (92%), followed by hematologic (55%). Of the total, 47 patients (62%) had criteria for multi-organ failure. The global mortality was 16%. Neurologic and renal dysfunction showed the strongest association with mortality, adjusted odds ratio 315 (26 - 3 804) and 155 (20 - 1 299). After application of receiver operating characteristic curves, Base Excess and Platelets score had an area under curve of 0.81, Paediatric Index of Mortality2 of 0.91 and Paediatric Risk of Mortality of 0.96.
  
  
  CONCLUSIONS
  The Base Excess and Platelets score showed good accuracy, although not as high as Paediatric Risk of Mortality or Paediatric Index of Mortality2.
  
  
  CONCLUSIONS
  The Base Excess and Platelets score may be useful tool in invasive meningococcal disease because is highly sensitive and specific and is objectively measurable and readily available at presentation.
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Luis
authors.initials: L
authors.lastname: Martins
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Mação
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Pinto
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Dionísio
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Andrea
authors.initials: A
authors.lastname: Dias
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Dinis
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: Leonor
authors.initials: L
authors.lastname: Carvalho
authors.affiliation: Serviço de Cuidados Intensivos Pediátricos. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
authors.forename: José Farela
authors.initials: JF
authors.lastname: Neves
mesh_terms: D000137:Acid-Base Imbalance / Q000097:blood* / Q000382:microbiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D008589:Meningococcal Infections / Q000097:blood* / Q000150:complications / Q000378:metabolism* / Q000382:microbiology; D010976:Platelet Count; D011174:Portugal; D012189:Retrospective Studies; D012720:Severity of Illness Index