Identifying Children at Risk of Malignant Bordetella pertussis Infection.

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dc.contributor.author Ganeshalingham, Anusha en
dc.contributor.author McSharry, Brent en
dc.contributor.author Anderson, Brian en
dc.contributor.author Grant, Cameron en
dc.contributor.author Beca, John en
dc.date.accessioned 2018-10-10T22:59:35Z en
dc.date.issued 2017-01 en
dc.identifier.issn 1529-7535 en
dc.identifier.uri http://hdl.handle.net/2292/40593 en
dc.description.abstract <label>OBJECTIVE</label>To identify factors associated with malignant pertussis.<label>DESIGN</label>A retrospective case notes review from January 2003 to August 2013. Area under the receiver-operator characteristic curve was used to determine how well vital sign and white cell characteristics within 48 hours of hospital presentation identified children with malignant pertussis.<label>SETTING</label>The national children's hospital in Auckland, New Zealand.<label>PATIENTS</label>One hundred fifty-two children with pertussis.<label>MEASUREMENTS AND MAIN RESULTS</label>There were 152 children with confirmed pertussis identified, including 11 children with malignant pertussis. The area under the receiver-operator characteristic curve was 0.88 (95% CI, 0.78-0.97) for maximum heart rate. The optimal cut-point was 180 beats/min, which predicted malignant pertussis with a sensitivity of 73% and a specificity of 91%. The area under the receiver-operator characteristic curve was 0.92 (95% CI, 0.81-1.0) for absolute neutrophil count, 0.85 (95% CI, 0.71-0.99) for total WBC count, 0.80 (95% CI, 0.63-0.96) for neutrophil-to-lymphocyte ratio, and 0.77 (95% CI, 0.58-0.92) for absolute lymphocyte count. All children with malignant pertussis had one or more of heart rate greater than 180 beats/min, total WBC count greater than 25 × 10/L, and neutrophil-to-lymphocyte ratio greater than 1.0 with an area under the receiver-operator characteristic curve of 0.96 (95% CI, 0.91-1.0) for a multivariate model that included these three variables.<label>CONCLUSIONS</label>Clinical predictors of malignant pertussis are identifiable within 48 hours of hospital presentation. Early recognition of children at risk of malignant pertussis may facilitate early referral to a PICU for advanced life support and selection for trials of investigational therapies. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Humans en
dc.subject Whooping Cough en
dc.subject Disease Progression en
dc.subject Leukocyte Count en
dc.subject Prognosis en
dc.subject Critical Care en
dc.subject Hospitalization en
dc.subject Severity of Illness Index en
dc.subject Risk Assessment en
dc.subject Risk Factors en
dc.subject Sensitivity and Specificity en
dc.subject Retrospective Studies en
dc.subject ROC Curve en
dc.subject Child en
dc.subject Child, Preschool en
dc.subject Infant en
dc.subject Infant, Newborn en
dc.subject Female en
dc.subject Male en
dc.subject Vital Signs en
dc.title Identifying Children at Risk of Malignant Bordetella pertussis Infection. en
dc.type Journal Article en
dc.identifier.doi 10.1097/pcc.0000000000001013 en
pubs.issue 1 en
pubs.begin-page e42 en
pubs.volume 18 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 27811532 en
pubs.end-page e47 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Journal Article en
pubs.elements-id 545860 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Anaesthesiology en
pubs.org-id Paediatrics Child & Youth Hlth en
pubs.record-created-at-source-date 2016-11-05 en
pubs.dimensions-id 27811532 en


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