Selected risk factors for mortality in children with HUS – a single-center analysis

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences Pub Date : 2026-09-01 Epub Date: 2026-10-06 DOI:10.1016/j.advms.2026.10.003

Ewelina Jarosz-Wójcik, Mateusz Zajączkowski, Dorota Drożdż, Magdalena Błasiak, Monika Miklaszewska

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引用次数: 0

Abstract

Purpose

The aim of the study was to describe clinical and laboratory characteristics of hemolytic-uremic syndrome (HUS), and identify prognostic factors, including risk factors for mortality and complications.

Materials and methods

It is a retrospective study of 74 pediatric patients (69 survivors and 5 non-survivors) with the first episode of HUS who were hospitalized in our tertiary reference center during 10-year period.

Results

Compared to survivors, non-survivors significantly more frequently developed neurological symptoms (100% vs. 31.9%), suffered from respiratory tract infections (80% vs. 27.5%), respiratory insufficiency (100% vs. 21.7%), circulatory failure (80% vs. 2.9%), and more often required renal replacement therapy (100% vs. 52.2%). In this group, there was a significant reduction in complement C3c and C4 components (0.67 vs. 0.97, 0.08 vs. 0.18, respectively). Elevated PCT, CRP, D-dimers, APTT, lipase, AST, GGTP and reduced C3c and C4 were associated with increased mortality risk. Severe neurological and ophthalmological complications, as well as circulatory insufficiency were the strongest predictors of death. Overall mortality rate was 6.8%.

Conclusions

Neurological (ischemic stroke, ophthalmological anomalies) and systemic (circulatory failure) complications may represent important determinants of outcome in pediatric HUS. Mortality also appears to be associated with systemic inflammatory activation and coagulopathy.

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溶血性尿毒综合征儿童死亡率的选定危险因素——单中心分析。

目的：本研究的目的是描述溶血性尿毒症综合征（HUS）的临床和实验室特征，并确定预后因素，包括死亡和并发症的危险因素。材料和方法：这是一项回顾性研究，74名儿童患者（69名幸存者和5名非幸存者）首次发作溶血性尿毒综合征在我们三级参考中心住院10年期间。结果：与幸存者相比，非幸存者更频繁地出现神经系统症状（100%对31.9%）、呼吸道感染（80%对27.5%）、呼吸功能不全（100%对21.7%）、循环衰竭（80%对2.9%），并且更频繁地需要肾脏替代治疗（100%对52.2%）。在该组中，补体C3c和C4成分显著减少（分别为0.67 vs 0.97, 0.08 vs 0.18）。PCT、CRP、d -二聚体、APTT、脂肪酶、AST、GGTP升高以及C3c和C4降低与死亡风险增加相关。严重的神经和眼科并发症以及循环功能不全是死亡的最强预测因子。总死亡率为6.8%。结论：神经系统（缺血性中风、眼科异常）和全身（循环衰竭）并发症可能是儿童溶血性尿毒综合征预后的重要决定因素。死亡率似乎也与全身炎症激活和凝血功能障碍有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.