Mortality and its correlation with diagnostic tests and treatment modalities in multisystem inflammatory syndrome in children admitted in tertiary care hospital of North India

Dr. Rakesh Kumar Sharma, Dr Ambika Sood, K. Azad, Deepak Sharma, Sanya Sharma
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Abstract

Background: The present study aimed to describe mortality and its correlation with diagnostic tests and treatment modalities among children admitted as a case multisystem inflammatory syndrome in children (MIS-C) in Indira Gandhi Medical College, Shimla. Materials and Methods: We conducted a cross-sectional study for MIS-C from January to July 2021, in the pediatric ward of a tertiary care hospital in North India. All children admitted with the diagnosis of MIS-C were included in the study. Data regarding sociodemographic factors and mortality were extracted and analyzed using Epi Info V7 software. Results: In the present study, a total of 31 children admitted as a case of MIS-C were included in the study. Of these, 23 (74.2%) were discharged after full recovery, 5 (16.1%) died during treatment, and 3 (9.7%) left the hospital against medical advice. Children presenting with severe illness, acidosis, azotemia, Hb<10gm%, Leukocytosis, abnormal RFTs, lipid profile, thrombocytopenia, deranged coagulogram, abnormal ECG, required pediatric intensive care, inotropic support, IVIG, Aspirin, LMWH, had a shorter hospital stay and a higher mortality. Statistical significance was seen with deranged renal function, thrombocytopenia, abnormal ECG, use of LMWH, and respiratory support. Conclusion: Mortality was significantly higher in children having shorter hospital stay <1 week, presenting with severe illness and deranged RFTs, thrombocytopenia, abnormal ECG, and requiring respiratory support, ventilatory support, and taking LMWH.
印度北部三级医院住院儿童多系统炎症综合征的死亡率及其与诊断试验和治疗方式的相关性
背景:本研究旨在描述西姆拉英迪拉甘地医学院收治的儿童多系统炎症综合征(MIS-C)病例的死亡率及其与诊断测试和治疗方式的相关性。材料和方法:我们于2021年1月至7月在印度北部一家三级医院的儿科病房对MIS-C进行了横断面研究。所有被诊断为misc的儿童都被纳入研究。使用Epi Info V7软件提取社会人口因素和死亡率数据并进行分析。结果:本研究共纳入31例misc患儿。其中,完全康复出院23例(74.2%),治疗期间死亡5例(16.1%),不遵医嘱出院3例(9.7%)。出现严重疾病、酸中毒、氮质血症、Hb<10gm%、白细胞增多、RFTs异常、血脂、血小板减少、凝血图紊乱、心电图异常、需要儿科重症监护、肌力支持、IVIG、阿司匹林、低分子肝素的儿童住院时间较短,死亡率较高。肾功能紊乱、血小板减少、心电图异常、低分子肝素使用和呼吸支持均有统计学意义。结论:住院时间短于1周、病情严重、RFTs紊乱、血小板减少、心电图异常、需要呼吸支持、通气支持、服用低分子肝素的患儿死亡率显著增高。
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