Capillary refill time as an independent prognostic indicator in severe and complicated malaria - 10/08/11
, Juergen May, MD, Daniel Ansong, MB, ChB, Sampson Antwi, MB, ChB, Emmanuel Asafo-Adjei, MB, ChB, Samuel Blay Nguah, MB, ChB, Kingsley Osei-Kwakye, MB, ChB, Alex Osei Yaw Akoto, MB, ChB, Alex Owusu Ofori, MB, ChB, David Sambian, Justice Sylverken, MB, ChB, Wibke Busch, Christian Timmann, MD, Tsiri Agbenyega, MB, ChB, PhD, Rolf D. Horstmann, MD
Reprint requests: Dr Jennifer Evans, Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.Résumé |
Objectives |
To improve algorithms for the identification of children at risk of dying of malaria in endemic areas.
Study design |
In a prospective study of 2446 children with severe and complicated malaria admitted to a tertiary referral center in Ghana, West Africa, 12 clinical and laboratory signs were evaluated as indicators of death.
Results |
A prolonged (>2 seconds) capillary refill time (pCRT) was identified as an independent prognostic indicator of death along with acidosis, coma, and respiratory distress. Among the clinical signs, pCRT increased the risk of dying from 4-fold to 11-fold when present in addition to coma and respiratory distress.
Conclusions |
The recognition of pCRT as an independent indicator of death justifies its inclusion as a defining criterion of severe and complicated malaria and improves the use of clinical examinations in the triage of patients with malaria. As pCRT has been shown to reflect circulatory disturbances in children, it should be included in upcoming studies as a possible sign to indicate the need for intravenous fluid administration.
Le texte complet de cet article est disponible en PDF.Abbreviations : BCS, CART, CF, CRT, pCRT, SMAC
Plan
| Supported by the German Ministry of Education and Research (BMBF) through the National Genome Research Network (NGFN, NIE-S17T19). |
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| T.A. is the Principal Investigator and D.A., S.A., E.A.A., S.B.N., K.O.K., A.O.Y.A., A.O.O., D.S., and J.S. are members of the Kumasi Severe Malaria in African Children (SMAC) Research Team. |
Vol 149 - N° 5
P. 676-681 - novembre 2006 Retour au numéro
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