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Correlative Analysis of Systemic Inflammatory Response Syndrome and Prognosis of Children with Critical Diseases

YANG Zhi-yong,WEI Dan(Department of Pediatrics,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China)  
Objective To perform a retrospective analysis of related prognostic factors of pediatric patients admitted in the pediatric intensive care unit(PICU),and to explore the possible correlation between the occurrence of systemic inflammatory response syndrome(SIRS) and the prognosis of patients with critical diseases in PICU.Methods Clinical data were collected in 431 pediatric patients with various diseases admitted from Jul.2006 to Dec.2007 in PICU,the first affiliated hospital of guangxi medical university.Assessments based on clinical indicators including pediatric critical illness score(PCIS),SIRS,as well as multiple organ dysfunction syndrome(MODS) were carried out for all patients,and statistical analysis was completed.Four hundred and thirty-one cases were divided into different groups by following factors.1.SIRS:SIRS group and non-SIRS group for the comparisons of its incidence rate,prognosis and PCIS value;2.PCIS:critical group(PCIS≤80) and non-critical group(PCIS80) for the comparisons of SIRS,MODS rate and mortality rate;3.prognosis:good prognosis(complete or partial recovery) and poor prognosis(deteriorating or morality) for the comparisons of SIRS rate and PCIS value.Additionally,their mortality rate was compared in the SIRS group with PCIS≤80 or PCIS80 and further did Spearman correlation analysis and Logistic regression analysis to all patients for the prognosis and its factors(age,gender,SIRS,infection,blood sodium/potassium/free calcium,CRP,PLT and PCIS value as well as blood sugar level).Results the SIRS rate of the subject patients in PICU was 48.3%.SIRS group featured higher MODS rate,lower PCIS value and worse prognosis than those in Non-SIRS group(Pa0.05);critical group had higher MODS rate and mortality rate than non-critical group(Pa0.05);poor prognosis group had higher SIRS rate,but lower PCIS value than good prognosis group(Pa0.05).In SIRS group,patients with PCIS≤80 had significantly higher mortality rate than that with PCIS80(P0.05).Single factor analysis suggested that the prognosis of all patients was positively correlated with PLT and PCIS value was negatively correlated with SIRS and CRP.Logistic regression analysis demonstrated that SIRS,thrombocytopenia,PCIS≤80,blood free calcium0.9 mmol/L,were all risk factors in poor prognosis.Conclusions SIRS pediatric patients are prone to complicated MODS and poor prognosis.SIRS serves as a single risk factor of prognosis to patients in PICU.
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