Affiliations: The Academic Department of Emergency Care, Bristol
Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
Note: [] Correspondence: Dr. Ahmed Sabra, The Academic Department of
Emergency Care, Bristol Royal Infirmary, Upper Maudlin Street Bristol BS2 8HW,
UK. Tel.: +44 (0)1173424363; Fax: +44 (0)1173422713; E-mail: drsabraa@yahoo.com
Abstract: Meningococcal disease is a global burden with an estimated annual
death rate of 170000 worldwide. The disease has an overall mortality greater
than 10%. Despite these figures, several studies demonstrate that the
management of children with severe meningococcal sepsis and septic shock is
suboptimal. Most children received inadequate fluid resuscitation and inotropic
support during their admission. Hence, this paper presents a review of relevant
literature of prediction studies and discusses clinical and methodological
issues, which may have influenced the results. It concludes that several
studies have investigated the predictors of a poor clinical outcome in this
condition, but there is a lack of studies that consider prediction of fluid and
inotrope requirements as an outcome measure. The identification of such
predictors would allow treatment to be directed to those children most likely
to benefit, with a long term goal of improving patient outcome.
Keywords: Meningococcal disease, prediction, clinical outcome, inotrope, children
