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PN Score of Peters et al for Pediatric Meningococcemia

Description

Peters et al reported the product of the platelet and absolute neutrophil counts in pediatric patients with clinical meningococcemia. This can help to identify a child at increased risk for mortality. The authors are from Great Ormond Street Hospital for Children, Institute of Child Health, University of Cambridge, Royal Manchester Childrens' Hospital and Addenbrooke's Hospital in England.


Patient selection: pediatric patient with clinical meningococcal disease

 

Outcome: mortality

 

Parameters:

(1) admission platelet count in 10^9/L

(2) admission absolute neutrophil count in 10^9/L

 

PN product =

= (platelet count) * (neutrophil count)

 

Interpretation:

• minimum product: 0

• maximum product: depends on counts, up to 1,000,000.

• A product < 40 was associated with mortality.

 

Performance:

• The reported area under the ROC curve is 0.97, but this seems high for the data presented.

• A score < 40 had a sensitivity of 83% and specificity of 100% in the derivation set.

• A score < 100 had a sensitivity of 83% and specificity of 96% in the derivation set.

• The sensitivity in the validation cohort was significantly lower.

• Performance was better for children less than 5 years of age.


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