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J Pediatr Intensive Care 2023; 12(03): 228-234
DOI: 10.1055/s-0041-1731434
Original Article

Performance of Platelet Mass Index as a Marker of Severity for Sepsis and Septic Shock in Children

Madhuradhar Chegondi 
1   Division of Pediatric Critical Care Medicine, Stead Family Children's Hospital, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
,
Niranjan Vijayakumar 
1   Division of Pediatric Critical Care Medicine, Stead Family Children's Hospital, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
,
Ramya Deepthi Billa
1   Division of Pediatric Critical Care Medicine, Stead Family Children's Hospital, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
,
Aditya Badheka 
1   Division of Pediatric Critical Care Medicine, Stead Family Children's Hospital, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States
,
Oliver Karam 
2   Division of Pediatric Critical Care Medicine, Children's Hospital of Richmond at VCU, Richmond, Virginia, United States
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Abstract

Platelet mass index (PMI) as a prognostic indicator in pediatric sepsis has not been previously reported. In this retrospective observational study, we evaluated PMI's performance as a prognostic indicator in children aged younger than 18 years with sepsis and septic shock in relationship with survival. Over 5 years, we collected data from 122 children admitted to our pediatric intensive care unit (PICU). PMI accuracy was assessed with sensitivity and specificity and its discrimination was assessed using the area under the receiver operating characteristic curve (AUC). Median PMI values on days 1 and 3 of PICU admission were lower among nonsurvivors. On day 1 of PICU admission, a cutoff PMI value of 1,450 fL/nL resulted in a sensitivity of 72% and a specificity of 69%, and the AUC was 0.70 (95% confidence interval [CI]: 0.55–0.86). Similarly, on day 3, a cutoff of 900 fL/nL resulted in a sensitivity of 71% and a specificity of 70%, and the AUC was 0.76 (95% CI: 0.59–0.92). Our exploratory study suggests that low PMI in children with septic shock is associated with increased mortality. Considering the PMI's fair performance, further studies should be performed to assess its clinical value.

Keywords

platelet mass index - area under curve - sensitivity and specificity - septic shock - children


Publication History

Received: 30 March 2021

Accepted: 20 May 2021

Article published online:
22 June 2021

© 2021. Thieme. All rights reserved.

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