Application value of pediatric critical illness scores combined with the detection of D-dimer and procalcitonin in early evaluation of the severity of pediatric infection condition

doi:10.3969/j.issn.1002-7386.2017.05.016

Abstract：Objective To investigate the early prediction and discriminant value of pediatric critical illness scores (PCIS) combined with the detection of D-dimer ( D-D) and procalcitonin ( PCT) for the severity of pediatric infection condition.Methods Eighty-six children patients with severe infectious disease who were treated in ICU of our hospital from October 2014 to September 2015 were enrolled in the study.According to pediatric critical cases scores ( PCIS), these children patients were divided into critical case group ( n =43,PCIS score:70 ~80),extremely critical case group ( n =43, PCIS score:under 70 points).The PCIS,serum levels of D-D and PCT were observed and compared between two groups .The correlation between PCIS and PCT as well as D-D was analyzed by means of Pearson correlation coefficient analysis ,moreover, the influencing factors on patient's death were analyzed by means of Logistic regression analysis .After 28-day follow-up, ROC curve analysis was used to analyze the prediction value of PCIS ,D-D and PCT for 28-day survival condition of patients .Results The serum levels of D-D and PCT in extremely critical case group were significantly higher than those in critical case group ( P <0.05).The serum levels of PCT and D-D were negatively correlated to PCIS ( P <0.05).Logistic regression analysis showed that PCT,D-D,PCIS were independent risk factors influencing patient's death.The area under ROC curve of PCT,D-D and PCIS in predicting 28-day survival condition of patients was 0.875,0.872 and 0.863,respectively ( P <0.01). Conclusion The serum levels of PCT and D-D in children patients with severe infection are important indexes to evaluate prognosis of disease condition ,which combined with PCIS has important guidance significance to evaluate prognosis of patients .