MENINGOCOCCAL SEPTIC SHOCK IN CHILDREN - CLINICAL AND LABORATORY FEATURES, OUTCOME, AND DEVELOPMENT OF A PROGNOSTIC SCORE

The clinical characteristics of and outcome for 75 children with menin gococcal septic shock were studied. in addition, a new prognostic scor ing system was developed. The median age of the patients was 3.2 years (range, 3 weeks to 17.9 pears). The most common phenotype of Neisseri a meningitidis was B:4:P1.4 (27%). A mortality rate of 21% was observe d. Ten (17%) of the 59 survivors had serious sequelae. Calcium levels were significantly lower in patients with seizures. Disseminated intra vascular coagulation occurred in 58% of the patients who were tested. Logistic regression analysis identified four laboratory features indep endently associated with mortality: serum C-reactive protein level, ba se excess, serum potassium level, and platelet count, These features w ere used to develop a novel scoring system with a predictive value for death and survival of 71% and 90%, respectively, The outcome was pred icted correctly for 86% of the patients, which is higher than rates pr eviously reported for scoring systems.