The following is a summary of “Predictive role of PAR and LAR in refractory suppurative meningitis in infants,” published in the July 2024 issue of Pediatrics by Gao et al.
Meningitis, which a variety of pathogenic microorganisms can trigger, presents a serious health concern due to its association with high mortality and disability rates. In infants and young children, the clinical manifestations of suppurative meningitis are often atypical, making early diagnosis challenging. Novel inflammatory biomarkers, such as the platelet/albumin ratio (PAR) and the lactate dehydrogenase/albumin ratio (LAR), have shown promise in other conditions like tumors, IgA nephropathy, and sepsis. This study investigates the potential application of these biomarkers in diagnosing and predicting the severity of refractory suppurative meningitis in infants.
This study aims to evaluate the utility of PAR and LAR as diagnostic and prognostic biomarkers for refractory suppurative meningitis in infants. Specifically, it seeks to determine if these ratios can effectively differentiate between common and refractory forms of the disease and predict clinical outcomes.
A retrospective analysis was conducted on the clinical data of 107 children diagnosed with suppurative meningitis and treated at a single tertiary care center. The children were divided into two groups based on disease severity: the common group (82 cases) and the refractory group (25 cases), by established clinical consensus guidelines. Clinical data, including demographics, clinical presentation, and laboratory results, were compared between the two groups. The diagnostic value of PAR and LAR was assessed using statistical methods, and a multivariate logistic regression analysis was performed to identify independent risk factors for poor prognosis.
The study revealed that children in the refractory group had significantly lower PAR values (P < 0.05) and higher LAR values (P < 0.05) compared to those in the common group. Multivariate logistic regression analysis identified high LAR and cerebrospinal fluid glucose levels ≤ 1.5 mmol/L as significant risk factors for poor prognosis (OR > 1, P < 0.05). In contrast, a higher PAR was found to be a protective factor (OR < 1, P < 0.05).
The findings suggest that PAR and LAR can serve as valuable biomarkers for the early diagnosis and prognosis of refractory suppurative meningitis in infants. Specifically, a high PAR appears protective, while a high LAR indicates a higher risk of poor outcomes. These biomarkers can help clinicians identify severe cases early, allowing for more targeted and timely therapeutic interventions. Incorporating PAR and LAR into clinical practice could enhance decision-making processes and improve the management of this critical pediatric condition, ultimately reducing mortality and improving long-term outcomes for affected infants.
Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-04898-6
