Clinical application of the pediatric early warning score in septic shock of leukemia children with neutrophil deficiency

Abstract:

Objective：To investigate the clinical application of the pediatric early warning score（PEWS） in septic shock of leukemia children with neutrophil deficiency. Methods：A total of 67 leukemia patients who suffered from neutrophil deficiency and complicated infection after chemotherapy in Children’s Hospital of Chongqing Medical University from January to December，2016 were included in the study as retrospective observation group. A retrospective study was performed on their clinical data. The PEWS was determined based on their monitoring data to establish the receiver operating characteristic curve and obtain the optimal cut-off value of PEWS for septic shock. A total of 72 leukemia patients who suffered from neutrophil deficiency and complicated infection after chemotherapy from January to December，2017 were included in the study as prospective study group. The PEWS was used for the early evaluation of the patients in the prospective study group. According to different PEWS values，the patients were given corresponding interven－tion measures，including anti-infective therapy，oxygen thera－py，fluid resuscitation，vasoactive agent，component transfusion，and recombinant activated protein C. The incidence rate of septic shock and the mortality rate due to septic shock were compared between the two groups. Results：The PEWS value of 3.5 was the optimal cut-off value for predicting septic shock in leukemia children with neutrophil deficiency，with a sensitivity of 83.3% and a specificity of 83.7%. The prospective study group had significantly lower incidence rate of septic shock and mortality rate due to septic shock than the retrospective observation group（P<0.01）. Conclusion：PEWS can be used for effective evaluation of condition and early identification of signs of septic shock in leukemia children with neutrophil deficiency. Accordingly，taking specific treat－ments and nursing interventions at the appropriate time will improve the prognosis of the disease.