Predictors of Winter et al for Death in an Infant Less 4 Months Old with Severe Pertussis

Description

Winter et al identified factors associated with mortality in an infant less than 4 months old with severe pertussis. These can help to identify a patient who may benefit from more aggressive management. The authors are from the California Department of Public Health and the University of California in Los Angeles.

Patient selection: infant less than 120 days old with severe pertussis

Major predictors:

(1) intubation (odds ratio 317.2)

(2) peak white blood cell count (odds ratio 1.06 per 1000 leukocytes per microliter)

(3) pulmonary hypertension (odds ratio 30)

Additional predictors:

(1) therapy with nitric oxide (odds ratio 4.4)

(2) seizure (odds ratio 4.2)

(3) birth weight (odds ratio 0.84 per 100 g)

where:

• Birth weight, WBC count, pulmonary hypertension and seizure were in one multivariate logistic regression model while intubation and nitric oxide therapy were in a second.

WBC Count	Birth Weight	Mortality
< 46,400 per µL	NA	1%
46,400 to 70, 399 per µL	>= 2,821 grams	23%
46,400 to 70, 399 per µL	< 2,821	100%
>= 70,400 per µL	NA	93%

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Predictors of Winter et al for Death in an Infant Less 4 Months Old with Severe Pertussis

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