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

Madhuradhar Chegondi; Niranjan Vijayakumar; Ramya Deepthi Billa; Aditya Badheka; Oliver Karam

doi:10.1055/s-0041-1731434

Journal of Pediatric Intensive Care, Inhaltsverzeichnis

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

¹Division of Pediatric Critical Care Medicine, Stead Family Children's Hospital, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States

,

Niranjan Vijayakumar

¹Division 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

¹Division of Pediatric Critical Care Medicine, Stead Family Children's Hospital, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States

,

Aditya Badheka

¹Division of Pediatric Critical Care Medicine, Stead Family Children's Hospital, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States

,

Oliver Karam

²Division of Pediatric Critical Care Medicine, Children's Hospital of Richmond at VCU, Richmond, Virginia, United States

› Institutsangaben

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

Volltext

Referenzen

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