RT Journal Article
SR Electronic
T1 Performance assessment of age-adapted SOFA, qSOFA, and PELOD-2, PCIS, P-MODS for Hand, Foot and Mouth Disease
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 606574
DO 10.1101/606574
A1 Zhenjun Yu
A1 Ali Li
A1 Tingting Huang
A1 Zebao He
A1 Huazhong Chen
A1 Jiansheng Zhu
YR 2019
UL http://biorxiv.org/content/early/2019/04/11/606574.abstract
AB Objectives Hand, foot and mouth disease (HFMD) is a common infectious disease in children caused by intestinal virus and an important cause of child death. Early identification of critical HFMD and timely intervention are the key to reduce mortality. However, there is no available unified critical HFMD screening standard. This study aimed to explore the predictive evaluation of HFMD with critical illness scoring systems.Methods A total of 31 patients with mild HFMD, 30 with severe HFMD, and 25 with critical HFMD were included. The platelet index in age-adapted sequential organ failure assessment score (SOFA) was re-assigned to constitute the SOFA for HFMD (H-SOFA). The results of age-adapted SOFA, quick SOFA (qSOFA), and pediatric logistic organ dysfunction score-2 (PELOD-2), pediatric multiple organ dysfunction score (P-MODS), pediatric critical illness score (PCIS), H-SOFA of the three groups were compared.Results Significant differences in the following parameters were found between severe group and critical group: enterovirus 71 positive, heart rate, respiration, vomiting, cold sweat, moist rales, disturbance in consciousness, platelet, and blood glucose (P<0.05), as well as all critical illness scoring data (P<0.001). age-adapted SOFA, qSOFA, and PELOD-2, P-MODS, H-SOFA were positively correlated with critical HFMD (odds ratio (OR): 3.213, 8.66, 2.64, 2.56, and 4.297 respectively; P<0.01), with area under the curve (AUC) values of 0.938, 0.823, 0.848, 0.910, and 0.956, respectively. PCIS was negatively correlated with critical HFMD (OR=0.76, P<0.001), with an AUC value of 0.865.Conclusion Increase in platelet count was related to the severity of HFMD. Age-adapted SOFA, qSOFA, and PELOD-2, P-MODS, PCIS, H-SOFA had high predictive value on critical HFMD, with H-SOFA being the highest.ALBalbuminALPalkaline phosphataseALTaminotransferaseANSautonomic nervous systemAPTTactivated partial thromboplastin timeASTaspartate transaminaseAUCarea under the ROC curveBIndependent variable coefficientBASObasophils countbpmbeats per minuteCaserum calciumCIconfidence intervalCKcreatine kinaseCKMBMB isoenzyme of creatine kinaseClserum chlorideCNScentral nervous systemCRPC-reactive proteinCV-A6coxsackie virus A group 6CV-A10coxsackie virus A group 10CV-A16coxsackie virus A group 16DBdirect bilirubindfdegrees of freedomEOeosinophils countEV-A71enterovirus A group 71FibfibrinogenGGTglutamyl transpeptidaseGLUblood glucoseHBhemoglobinHCThematocritHFMDhand foot and mouth diseaseH-SOFAAge-adapted SOFA for Hand Foot and Mouth DiseaseIBindirect bilirubinIgAimmunoglobulin AIgGimmunoglobulin GIgMimmunoglobulin MKserum potassiumLDHlactate dehydrogenaseLYMPlymphocytes countMAPmean arterial pressureMONOmonocytes countNasodiumNEUTneutrophils countNHCCNational Health Commission of ChinaORodds ratioPBprealbuminPCISPediatric Critical Illness ScorePCTprocalcitoninPELOD-2Pediatric Logistic Organ Dysfunction Score-2PLTplateletP-MODSPediatric Multiple Organ Drgan Dysfunction ScorePTprothrombin timeqSOFAquick Sequential Organ Failure Assessment ScoreROCreceiver operating characteristicSCrserum creatinineSEstandard errorSOFASequential Organ Failure Assessment ScoreTBtotal bilirubinUAuric acidWBCwhite blood cell countWHOworld health organization