Significance of pediatric early warning score and inflammatory markers in early diagnosis of critical hand foot and mouth disease / 医学研究生学报

ABSTRACT

Objective Critical hand foot and mouth disease(HFMD)progresses from severe type to critical type very fast with high mortality rate.The article was to explore the significance of pediatric early warning score and common inflammatory markers in early diagnosis of critical HFMD cases. Methods A retrospective analysis was conducted on 236 HFMD cases in Hainan Provincial People's Hospital from January 2014 to December 2016. According to HFMD diagnosis and treatment guidelines(2010 Edition)formulated by the Ministry of Health,the selected cases were divided into the general group(n=88),the severe group(n=128)and the critical group(n=20). The white blood cells(WBC),neutrophils(PMN), serum C reactive protein(CRP),procalcitonin(PCT)and other la-boratory parameters were collected at admission,along with Pediatric Early Warning score(PEWS)and Pediatric Critical Illness Score(PCIS). The data of each group were compared by ROC curve analysis. Results The median number of WBC and PMN in the criti-cal group was 15.36×109/L and 10.09×109/L,respectively,which were significantly higher than those of severe group(P<0.05). However,no significant difference was found between general group and severe group(P>0.05). The serum levels of CRP and PCT in general group were higher than those in severe group and critical group,and the difference was statistically significant(P<0.05). The PEWS[(6.1±2.42)vs(0.99±0.77)]and PCIS[(78.7±13.6)vs(99.03±2.12)]in critical group were significantly higher than those in severe group,which were of statistically significance(P<0.05). According to the ROC analysis,the area under the ROC curve of PEWS early warning score for children was(0.962~1.000),(P<0.05)and the best diagnosis limit PEWS was 3.5. The PEWS and PCIS correlation analysis showed the Pearson correlation coefficient was -0.885(P<0.05). Conclusion Common clini-cal inflammatory markers can not be taken as quantitative indicators for the early diagnosis of critical HFMD. The PEWS is an ideal quantitative index for early diagnosis of critical HFMD.