Clinical characteristics and predictors of adverse outcomes in children with acute rheumatic fever from a high-endemic region of Brazil - Summary - MDSpire
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Clinical characteristics and predictors of adverse outcomes in children with acute rheumatic fever from a high-endemic region of Brazil
To characterize the clinical profile of pediatric ARF and identify readily available predictors of adverse outcomes in a high-endemic region of Brazil, emphasizing the importance of these predictors in guiding timely management in resource-limited settings.
Key Findings:
151 children included, median age 9 years, 46% female. Findings suggest significant implications for clinical management.
76% had carditis, with 49% having moderate-to-severe involvement.
13% experienced the primary outcome during a median follow-up of 17.5 months.
Absence of fever, higher ESR, and lower hematocrit were independently associated with adverse outcomes.
Incorporating ESR improved risk prediction with significant net reclassification improvement.
Interpretation:
Simple inflammatory and hematologic markers are associated with progression to severe outcomes in children with ARF.
Limitations:
Study conducted in a single center, which may limit generalizability.
Potential biases in retrospective data collection, including incomplete records and selection bias.
Conclusion:
ESR, an inexpensive and accessible test, provides incremental prognostic information and may support risk stratification strategies in resource-limited settings, ultimately improving patient outcomes.
by Renata Fonseca Mendoza, Letícia Leão de Oliveira, Bernardo Fonseca Mendoza, Jose Luiz Padilha da Silva, Paulo Henrique M. Melo, José Augusto Almeida Barbosa, Géssica Silva Santana, Airandes Pinto, Ndate Fall, Andrea Beaton, Maria Carmo Pereira Nunes
Damon B. Dixon, MD, at Phoenix Children’s Cardiology, is the author to this EndoText chapter. Dr. Dixon brings nationally recognized expertise in pediatric cardiovascular risk assessment and non?invasive vascular imaging.
