Evaluating The Predictive Value Of MRSHFMD Score In The Complications Of Children With Hand Foot And Mouth Disease In PICU

Objective: This study intended to analyze the predictive value of the MRSHFMD scoring system for the complications and mortality risk.Methods: This study included 382 children with severe hand,foot and mouth disease who treated in the Pediatric Intensive Care Unit of Hunan Provincial Children's Hospital from March 2012 to June 2014.According to the course of disease whether occurrence nervous system injury,pulmonary edema,pulmonary hemorrhage and circulatory failure to identify complication groups.And according 28-day survival condition after hospital admission to identify outcome groups.The worst values of GLU?WBC?LAC and NT-proBNP within 24 hours after admission were used to score MRSHFMD.The predictive value of MRSHFMD for nervous system injury,pulmonary edema,pulmonary hemorrhage,circulatory failure,and prognosis was evaluated using the receiver operating characteristic(ROC)curve.Results: The mortality rate of patients with and without nervoussystem injury,pulmonary edema,pulmonary hemorrhage,circulatory failure was significantly higher(P<0.05).WBC,GLU,NT-proBNP,and MRSHFMD scores in the group with complications were significantly higher than those without complications(P<0.05).When the MRSHFMD score was 3 points,the area under the receiver operating characteristic(ROC)curve and its 95%CI were 0.703(0.654-0.748)? 0.849(0.809-0.883)?0.93(0.90-0.954)?0.917(0.885-0.943),and 0.98(0.961-0.992)to discriminate between patients with and without nervous system injury,pulmonary edema,pulmonary hemorrhage,circulatory failure,and death,respectively.Conclusions: Our study found that the MRSHFMD scoring system was an effective and simple tool to predict complications of pulmonary hemorrhage,circulatory failure,and death in severe hand,foot and mouth disease,which is conducive to application for clinicians.