Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study

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dc.contributor.authorSık G.
dc.contributor.authorInamlık A.
dc.contributor.authorAkçay N.
dc.contributor.authorKesici S.
dc.contributor.authorAygun F.
dc.contributor.authorKendırlı T.
dc.contributor.authorAtay G.
dc.contributor.authorSandal O.
dc.contributor.authorVarol F.
dc.contributor.authorOzkaya P.Y.
dc.contributor.authorDuyu M.
dc.contributor.authorBırbılen A.Z.
dc.contributor.authorOzcan S.
dc.contributor.authorArslan G.
dc.contributor.authorKangın M.
dc.contributor.authorBayraktar S.
dc.contributor.authorAltug U.
dc.contributor.authorAnıl A.B.
dc.contributor.authorHavan M.
dc.contributor.authorYetımakman A.F.
dc.contributor.authorDalkıran T.
dc.contributor.authorZengın N.
dc.contributor.authorOto A.
dc.contributor.authorKıhtır H.S.
dc.contributor.authorGırgın F.İ.
dc.contributor.authorTelhan L.
dc.contributor.authorYıldızdas D.
dc.contributor.authorYener N.
dc.contributor.authorYukselmıs U.
dc.contributor.authorAlakaya M.
dc.contributor.authorKılınc M.A.
dc.contributor.authorCelegen M.
dc.contributor.authorDursun A.
dc.contributor.authorBattal F.
dc.contributor.authorSarı F.
dc.contributor.authorOzkale M.
dc.contributor.authorTopal S.
dc.contributor.authorKocaoglu C.
dc.contributor.authorYazar A.
dc.contributor.authorAlacakır N.
dc.contributor.authorOdek C.
dc.contributor.authorYaman A.
dc.contributor.authorCıtak A.
dc.contributor.authorBıngol I.
dc.contributor.authorAnnayev A.
dc.contributor.authorSevketoglu E.
dc.contributor.authorKatlan B.
dc.contributor.authorDurak C.
dc.contributor.authorGun E.
dc.contributor.authorErdogan S.
dc.contributor.authorSeven P.
dc.contributor.authorSahın E.
dc.contributor.authorArı H.F.
dc.contributor.authorBoyraz M.
dc.contributor.authorDurak F.
dc.contributor.authorEmeksız S.
dc.contributor.authorOzdemır G.
dc.contributor.authorDuman M.
dc.contributor.authorTalay M.N.
dc.contributor.authorYener G.O.
dc.contributor.authorLuleyap D.
dc.contributor.authorHarmanogulları S.
dc.contributor.authorBaşar E.Z.
dc.contributor.authorMercan M.
dc.contributor.authorBal A.
dc.contributor.authorKılıc N.
dc.contributor.authorOngun E.A.
dc.contributor.authorOzturk M.N.
dc.contributor.authorEkıncı F.
dc.contributor.authorUdurgucu M.
dc.contributor.authorArslankoylu A.E.
dc.contributor.authorKutlu N.O.
dc.contributor.authorBukulmez A.
dc.contributor.authorÖzsoylu S.
dc.contributor.authorCelık T.
dc.contributor.authorOzkale Y.
dc.contributor.authorKılıc A.O.
dc.date.accessioned2024-07-22T08:02:35Z
dc.date.available2024-07-22T08:02:35Z
dc.date.issued2023
dc.description.abstractBackground: This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. Results: The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. Conclusions: In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. Impact: MIS-C is a life-threatening condition.Patients need to be followed up in the intensive care unit.Early detection of factors associated with mortality can improve outcomes.Determining the factors associated with mortality and length of stay will help clinicians in patient management.High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients.We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. © 2023, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
dc.identifier.DOI-ID10.1038/s41390-023-02518-0
dc.identifier.issn00313998
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11918
dc.language.isoEnglish
dc.publisherSpringer Nature
dc.rightsAll Open Access; Bronze Open Access
dc.subjectChild
dc.subjectCohort Studies
dc.subjectCritical Illness
dc.subjectHumans
dc.subjectIntensive Care Units, Pediatric
dc.subjectLactates
dc.subjectpediatric multisystem inflammatory disease, COVID-19 related
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectSystemic Inflammatory Response Syndrome
dc.subjectalanine aminotransferase
dc.subjectalbumin
dc.subjectamino terminal pro brain natriuretic peptide
dc.subjectC reactive protein
dc.subjectcorticosteroid
dc.subjectcreatine kinase MB
dc.subjectcreatinine
dc.subjectD dimer
dc.subjectdopamine
dc.subjectepinephrine
dc.subjectferritin
dc.subjectglucocorticoid
dc.subjectglucose
dc.subjecthypertensive factor
dc.subjectimmunoglobulin
dc.subjectinterleukin 6 inhibitor
dc.subjectlactic acid
dc.subjectlow molecular weight heparin
dc.subjectmilrinone
dc.subjectnoradrenalin
dc.subjectpotassium
dc.subjectprocalcitonin
dc.subjectprothrombin
dc.subjectrecombinant interleukin 1 receptor antagonist
dc.subjectsodium
dc.subjecttroponin
dc.subjectlactic acid derivative
dc.subjectacute lymphoblastic leukemia
dc.subjectanticoagulation
dc.subjectArticle
dc.subjectartificial ventilation
dc.subjectcardiovascular system
dc.subjectcerebral palsy
dc.subjectchild
dc.subjectclinical evaluation
dc.subjectclinical feature
dc.subjectclinical outcome
dc.subjectcohort analysis
dc.subjectcomorbidity
dc.subjectcongenital heart disease
dc.subjectcontrolled study
dc.subjectcoronary artery aneurysm
dc.subjectcritical illness
dc.subjectcritically ill patient
dc.subjectdemographics
dc.subjectdisease course
dc.subjectdisease duration
dc.subjectdisease severity
dc.subjectdrug megadose
dc.subjectfemale
dc.subjectheart arrhythmia
dc.subjecthematologic disease
dc.subjecthematology
dc.subjecthospital admission
dc.subjecthuman
dc.subjecthypoalbuminemia
dc.subjectintracardiac thrombosis
dc.subjectkidney disease
dc.subjectlaboratory test
dc.subjectleukocyte count
dc.subjectlow drug dose
dc.subjectlymphocytopenia
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmortality rate
dc.subjectmortality risk
dc.subjectmulticenter study (topic)
dc.subjectneurologic disease
dc.subjectorgan systems
dc.subjectoutcome assessment
dc.subjectpediatric intensive care unit
dc.subjectpediatric multisystem inflammatory syndrome
dc.subjectplasma exchange
dc.subjectrespiratory tract disease
dc.subjectretrospective study
dc.subjectrisk factor
dc.subjectshock
dc.subjectsymptom
dc.subjectthrombocytopenia
dc.subjecttreatment duration
dc.subjecttreatment indication
dc.subjectclinical trial
dc.subjectmulticenter study
dc.subjectrisk factor
dc.subjectsystemic inflammatory response syndrome
dc.titleMortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study
dc.typeArticle

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