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

2023; Springer Nature; Volume: 94; Issue: 2 Linguagem: Inglês

10.1038/s41390-023-02518-0

1530-0447

Güntülü Şık, Aysegul Inamlık, Nihal Akçay, Selman Kesici, Fatih Aygün, Tanıl Kendirli, Gürkan Atay, Özlem Saraç Sandal, Fatih Varol, Pınar Yazici, Muhterem Duyu, Ahmet Ziya Bırbılen, Serhan Özcan, Gazi Arslan, Murat Kanğın, Süleyman Bayraktar, Ümit Altuğ, Ayşe Berna Anıl, Merve Havan, Ayşe Filiz Yetimakman, Tahir Dalkıran, Neslihan Zengın, Arzu Oto, Hasan Serdar Kıhtır, Feyza İnceköy Gırgın, Leyla Telhan, Dinçer Yıldızdaş, Nazik Yener, Ufuk Yükselmiş, Mehmet Alakaya, Mehmet Kılınç, Mehmet Çeleğen, Adem Dursun, Fatih Battal, Ferhat Sarı, Murat Özkale, Sevgi Topal, Çelebi Kocaoğlu, Abdullah Yazar, Nuri Alacakır, Çağlar Ödek, Ayhan Yaman, Agop Çıtak, İbrahim Bingöl, Agageldi Annayev, Esra Şevketoğlu, Banu Katlan, Cansu Durak, Emrah Gün, Seher Erdoğan, Pınar Seven, Ebru Şahin, Hatice Feray Arı, Merve Boyraz, Fatih Durak, Serhat Emeksız, Göktuğ Özdemir, Murat Duman, Mehmet Nur Talay, Gülçin Otar Yener, Doga Luleyap, Sezer Harmanogulları, Eviç Zeynep Başar, Mehmet Mercan, Alkan Bal, Nevin Kılıç, Ebru Atike Ongun, Makbule Öztürk, Faruk Ekıncı, Muhammed Üdürgücü, Ali Ertuğ Arslanköylü, Nurettin Onur Kutlu, Ayşegül Bükülmez, Serkan Özsoylu, Taylan Çelik, Yasemin Özkale, Ahmet Osman Kılıç,

Pneumonia and Respiratory Infections

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.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.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.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.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.