Abstract:

Objective To investigate the relationship between clinical characteristics and pediatric critical illness score in children with severe Mycoplasma pneumoniae pneumonia (MPP).Methods Retrospective analysis was utilized for the clinical data (age, sex, duration of fever, laboratory examination, outcome of ECG，chest X-ray and CT within 48 h after admission) of the children who were hospitalized at PICU of Fujian Maternity and Children Health Hospital due to severe MPP from January 2014 to December 2015. According to the pediatric critical illness score (PCIS) criteria, patients were divided into extremely critical group (PCIS<70), critical group (80>PCIS>70) and non-critical group (PCIS>80). The clinical characteristics were screened by univariate analysis, and then statistically significant clinical markers were analyzed by multivariate logistic regression analysis. These comparison and analysis were conducted with regard to the relationship between their clinical characteristics and PCIS.Results A total of 114 children hospitalized with severe MPP were enrolled, including 61 males and 53 females. Cardiovascular system damage was found in 29 cases, 23 cases were with digestive system damage, 18 cases with nervous system damage, 27 cases with hematological system damage. They were divided into 3 groups in accordance with PCIS: 77 were in non-critical group, 30 were in critical group, 7 were in extremely critical group. Among three groups, there were no significantly differences in age and sex. There were statistical significances in the proportions of abnormal electrocardiographic pattern, extrapulmonary complications of 2 or more organ damages, co-infection of 2 or more noxaes and course of disease more than 12 days. Prealbumin level decreased and D-Dimer level increased among three groups, both with statistical significance. Multivariate logistic regression analysis showed there was positive correlation between the proportions of co-infection of 2 or more noxaes (OR=7.147,95%CI: 1.435 to 35.59), D-Dimer level (OR=1.507,95%CI：1.054 to 2.156) and PCIS, there was negative correlation between prealbumin level (OR=0.914,95%CI:0.845 to 0.990) and PCIS in children.Conclusion Co-infection of 2 or more noxaes, D-Dimer, prealbumin may be related to the severity of severe MPP.