https://scholars.lib.ntu.edu.tw/handle/123456789/526889
標題: | Prognostic value of B-type natriuretic peptide, leukocytosis, and hyperglycemia in children with severe hand, foot, and mouth disease | 作者: | CHIEN-CHANG LEE Lu X. Xiao Z. Yang M. Zhu Y. |
公開日期: | 2016 | 卷: | 45 | 期: | 6 | 起(迄)頁: | 620-625 | 來源出版物: | Shock | 摘要: | Objective: Our goal is to determine the prognostic value of serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP), leukocytosis, and hyperglycemia in patients with severe hand, foot, and mouth disease (HFMD). Design: This is a prospective cohort study conducted from March 2011 through October 2012 at Hunan Children's Hospital. Setting: Hunan Children's Hospital, a large children's teaching hospital with 1,500-beds located in the Changsha region of Hunan Province in China. Patients: 295 children who were presented with clinical manifestation of severe HFMD, and required hospitalization. Interventions: Standard supportive treatment for HFMD as recommended by the national guidelines. Measurements: Admission blood samples were analyzed for NT-proBNP, leukocyte count, and serum glucose. Independent prognostic value of NT-proBNP for predicting mortality was evaluated using the Cox proportional hazard model adjusting for various covariates. Main Results: Area under the curve of receiver operating characteristic (AUROC) analysis suggested that a serum concentration of NT-proBNP concentration more than 1,500 pg/mL is an optimal cutoff point. Twenty-four patients (8.1%) had an NT-proBNP more than 1,500 pg/mL, and a 3-day mortality of 46% (11/24). Adjusted for tachycardia, tachypnea, hypertension, hyperglycemia, leukocytosis, and conscious disturbance on presentation, elevated NT-proBNP was associated with a 22.5-fold (95% confidence interval, 3.56-142.66) increased risk of 3-day mortality. We have further improved the specificity and AUROC values by the HFMD laboratory score, which combines NT-proBNP, leukocytosis, and hyperglycemia. Conclusions: Routine admission surveillance for NT-proBNP is useful for identifying patients with HFMD at risk for mortality. Further studies are needed to determine whether early intervention in patients with highly elevated NT-proBNP can improve outcome. ? 2015 by the Shock Society. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/526889 | ISSN: | 1073-2322 | DOI: | 10.1097/SHK.0000000000000545 | SDG/關鍵字: | brain natriuretic peptide; glucose; biological marker; brain natriuretic peptide; peptide fragment; pro-brain natriuretic peptide (1-76); Article; aseptic meningitis; blood sampling; child; clinical trial; cohort analysis; consciousness disorder; diagnostic accuracy; diagnostic value; encephalitis; female; glucose blood level; hand foot and mouth disease; heart muscle injury; hormone blood level; hospitalization; human; hyperglycemia; hypertension; leukocyte count; leukocytosis; lung edema; lung hemorrhage; major clinical study; male; mortality; neurological complication; pilot study; practice guideline; preschool child; prognosis; prospective study; respiratory failure; shock; tachycardia; tachypnea; teaching hospital; blood; China; hand foot and mouth disease; hospital; hyperglycemia; Kaplan Meier method; leukocytosis; predictive value; prognosis; sensitivity and specificity; university hospital; Biomarkers; Child, Preschool; China; Female; Hand, Foot and Mouth Disease; Hospitals, Pediatric; Hospitals, University; Humans; Hyperglycemia; Kaplan-Meier Estimate; Leukocytosis; Male; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Prognosis; Prospective Studies; Sensitivity and Specificity |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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