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

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dc.authoridongun, ebru atike/0000-0002-1248-8635
dc.authoridBukulmez, Aysegul/0000-0002-6013-5172
dc.authoridKOCAOGLU, CELEBI/0000-0002-6928-9186
dc.authoridArslan, Gazi/0000-0002-8616-3761
dc.authoridKutlu, Nurettin Onur/0000-0002-3306-6570
dc.authoridÖdek, Çağlar/0000-0002-2521-3411
dc.authoridAkçay, Nihal/0000-0002-8273-2226
dc.authorwosidongun, ebru atike/L-5719-2015
dc.authorwosidŞık, Guntulu/H-2340-2018
dc.authorwosidBukulmez, Aysegul/A-8528-2018
dc.authorwosidKOCAOGLU, CELEBI/I-9013-2016
dc.authorwosidArslan, Gazi/AAM-5214-2021
dc.authorwosidKutlu, Nurettin Onur/AAW-6196-2021
dc.authorwosidÖdek, Çağlar/AAK-3629-2020
dc.contributor.authorSik, Guntulu
dc.contributor.authorInamlik, Aysegul
dc.contributor.authorAkcay, Nihal
dc.contributor.authorKesici, Selman
dc.contributor.authorAygun, Fatih
dc.contributor.authorKendirli, Tanil
dc.contributor.authorAtay, Gurkan
dc.date.accessioned2024-05-19T14:50:35Z
dc.date.available2024-05-19T14:50:35Z
dc.date.issued2023
dc.departmentİstinye Üniversitesien_US
dc.description.abstractBackgroundThis 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.MethodsA 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.ResultsThe 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.ConclusionsIn 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.ImpactMIS-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.en_US
dc.identifier.doi10.1038/s41390-023-02518-0
dc.identifier.endpage737en_US
dc.identifier.issn0031-3998
dc.identifier.issn1530-0447
dc.identifier.issue2en_US
dc.identifier.pmid36813951en_US
dc.identifier.scopus2-s2.0-85148522451en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage730en_US
dc.identifier.urihttps://doi.org10.1038/s41390-023-02518-0
dc.identifier.urihttps://hdl.handle.net/20.500.12713/5751
dc.identifier.volume94en_US
dc.identifier.wosWOS:000941544900001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherSpringernatureen_US
dc.relation.ispartofPediatric Researchen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.snmz20240519_kaen_US
dc.subjectMultisystem Inflammatory Syndromeen_US
dc.subjectDiseaseen_US
dc.subjectUpdateen_US
dc.titleMortality risk factors among critically ill children with MIS-C in PICUs: a multicenter studyen_US
dc.typeArticleen_US

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