Clinical Study On The Value Of Albumin Corrected Anion Gap In Evaluating The Prognosis Of Death In Children With Severe Pneumonia And Central Nervous System Infection

Part ? Analysis of the composition of death causes of inpatients in the pediatrics of the Affiliated Hospital of North Sichuan Medical College from 2014 to 2018Objective:Analyzing the medical records of inpatients who died in the pediatrics of the Affiliated Hospital of North Sichuan Medical College from 2014 to 2018,to find out the composition of death causes.Methods:The medical records of inpatients who died in pediatrics of the Affiliated Hospital of North Sichuan Medical College from 2014 to 2018 were analyzed retrospectively.The death patients were divided into 1?12 months group?1?5 years old group??5 years old group,and we analyzed the composition of death causes.Results:1.A total of 61 patients died,including 36 males and 25 females,22 children aged 1?12 months(36.07%)?21 children aged 1?5 years old(34.43%)and 18 children aged?5 years old(29.51%);2.The top three causes of death were:respiratory diseases(39.34%),neurological diseases(26.23%),and tumor(9.84%);3.Severe pneumonia was the main component of respiratory diseases(95.83%),and central nervous system infection was the main component of neurological diseases(81.25%);4.Respiratory diseases(68.18%)in children aged 1?12 months were the top cause of death.Among children aged 1?5 years old,the main causes of death were neurological diseases(38.10%)and respiratory diseases(33.33%).Among children ?5 years old,the main causes of death were neurological diseases(33.33%)and tumors(22.22%).The proportion of death from respiratory diseases gradually decreased with age(P=0.001);and there was no statistically significant difference in the proportion of neurological diseases among different age groups(P>0.05).Conclusion:Among the 61 children who died,the proportion of children who died under 5 years old was as high as 70.49%,which was a high-risk age stage.The top three causes of death were:respiratory diseases?neurological diseases?and tumors;severe pneumonia was the main component of respiratory diseases,and central nervous system infection was the main component of neurological diseases.The causes of death changed with age,respiratory diseases and neurological diseases were the main causes in infants,while neurological diseases and tumors were the main causes in older children.Part ? Clinical study on the value of albumin corrected anion gap and other indicators in evaluating the prognosis of death in children with severe pneumonia and central nervous system infectionObjective:To explore the value of albumin corrected anion gap and other indicators in evaluating the prognosis of death in children with severe pneumonia and central nervous system infection.Methods:23 cases of children who died of severe pneumonia and 13 cases of children who died of central nervous system infection during pediatric hospitalization in the Affiliated Hospital of North Sichuan Medical College from January 2014 to January 2018 were collected.The control group randomly selected 80 cases of children with severe pneumonia and 40 cases of children with central nervous system infection who were discharged after treatment during the same period.The blood gas analysis and liver function of the children in the death group and the control group on the day of admission were collected to obtain indicators such as NA+?K+?CL-?HCO3-?albumin(ALB)?lactic acid(LAC).The formulas:anion gap(AG)=NA++K+-CL--HCO3-;ACAG=AG+(40-ALB)×0.25(ALB unit is g/L)were used to calculate AG and ACAG,then we analyzed the differences of ACAG and other indicators between the death group and the survival group.Results:1.In the group of severe pneumonia,the levels of ACAG?AG?and LAC in the death group were higher than those in the survival group,and the level of ALB was lower than that in the survival group(P<0.05);Logistic regression analysis suggested that ALB was a protective factor for prognosis of death in children with severe pneumonia,while ACAG?AG?LAC were risk factors;The receiver operating characteristic(ROC)curve suggested that ACAG had the best prognostic value.2.In the group of central nervous system infection,the levels of ACAG?AG?and LAC in the death group were also higher than those in the survival group,and the level of ALB was lower than that in the survival group(P<0.05);Logistic regression analysis suggested ACAG?AG and LAC were risk factors for prognosis of death in children with central nervous system infection,and the ROC curve suggested us ACAG had the best prognostic value.Conclusion:ACAG?AG and LAC can all be used as risk factors for prognosis of death in children with severe pneumonia and central nervous system infection,and ACAG had the best prognostic value.