Background: HSP is a common, usually benign, arteritis which may follow a protracted course with prolonged length of hospital stay.
Objective: To determine clinical characteristic which predict prolonged LOS in pediatric HSP.
Methods: We retrospectively reviewed charts of all consecutive HSP patients admitted to the Dana-Duek Childrens hospital in last 13 years for demographics, LOS, signs, symptoms and laboratory data. In univariate analysis we studied the correlation between each one of these variables and LOS. Variables that significantly predicted LOS were analyzed in stepwise backward multiple regression analysis. Variables that remained significant in the final analysis were given a specific weight (according to their contribution to the final R square) and used to assemble an HSP severity score. Discriminant analysis was used to determine the score best discriminating patients with prolonged LOS (4 or more days).
89 children (9mo-17yrs) were retrieved.
In univariate analysis, variables that correlated with LOS and were included in the score were: sole abdominal pain at presentation (0 or 3 points), Fever above 38.0 (0 or 2 points), CRP≥45 (0 or 1 point) and Age≥6 (0 or 0.5 points).
All these variables remained significant in multiple regression. A score of≥3 predicted prolonged LOS with a sensitivity of 76%, a specificity of 79% and a positive predictive value of 93%.
Conclusion: 4 selected variables available on the day of admission allow predicting the severity (in terms of LOS) of HSP in a satisfactory manner. This score will be prospectively validated in an ongoing study.
