Background: With the increase in pediatric obesity, the prevalence of metabolic syndrome (MetS) is rising worldwide. Early identification of children with obesity who are prone to developing MetS is important. Objectives: This study aimed to evaluate the value of the Systemic Immune–Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI) in predicting MetS in obese children and adolescents. Methods: This prospective single-center cross-sectional study involved 99 children and adolescents with obesity. The patients were assigned to two groups, MetS+ (n = 42) and MetS- (n = 57), based on the presence of MetS. Complete blood count results from the first visit were evaluated. Results: The white blood cell (WBC), platelet, and neutrophil counts were higher in the MetS+ group (P = 0.003, P = 0.022, and P < 0.001, respectively), while no significant difference was observed in lymphocyte (P = 0.865) and monocyte counts (P = 0.488) between the two groups. When inflammatory parameters were compared, SII (P < 0.001), platelet-to-lymphocyte ratio (PLR) (P = 0.024), neutrophil-to-lymphocyte ratio (NLR) (P = 0.002), and SIRI (P = 0.012) were significantly elevated in the MetS+ group compared to the MetS- group. Binary logistic regression analysis revealed that SII and homeostasis model assessment of insulin resistance (HOMA-IR) were statistically significant risk factors for the presence of MetS (P = 0.003, P = 0.012, respectively). Additionally, a significant positive correlation was found between SII and diastolic blood pressure (DBP) (P = 0.024), high-density lipoprotein cholesterol (HDL-C) (P = 0.019), and fasting plasma glucose (FPG) (P = 0.048), as well as between SIRI and HDL-C (P = 0.044) and FPG (P < 0.001). Receiver operating characteristic analysis of the SII and SIRI ability to predict MetS in adolescents and children with obesity showed that the SII was more discriminative than the SIRI, with a specificity of 0.82, sensitivity of 0.57, and an area under the curve of 0.708. Conclusions: The SII and SIRI can be used for the early diagnosis of MetS in pediatric obesity patients.

Background: This study investigated the relationship between initial lactate levels and both mortality and morbidity in critically ill pediatric trauma patients requiring intensive care.Methods: This retrospective study at tertiary center’s pediatric intensive care unit from January 2020 to June 2024 aimed to characterize trauma patients and assess admission lactate levels' prognostic value.Results: A total of 190 critically ill pediatric trauma patients were included in the study. The mortality rate was 7.9%, with most deaths occurring within the first 48 hours of admission. Initial lactate levels ≥6.9 mmol/L demonstrated moderate predictive power (area under the curve [AUC], 0.878) for mortality. Pediatric Risk of Mortality III (PRISM III) score showed good predictive ability (AUC, 0.922), while Pediatric Trauma Scores exhibited variable predictive performance (AUC, 0.863). Higher initial lactate levels were significantly associated with severe brain injury, the need for intubation, and an increased incidence of thoracic or abdominal injuries.Conclusions: Initial lactate levels and PRISM III score are effective predictors of mortality in critically ill pediatric trauma patients. Lactate levels ≥5 mmol/L upon admission should prompt close monitoring and consideration of aggressive management strategies.

This study aimed to compare the predictive value of Pediatric Early Warning Score (PEWS) to Pediatric Risk of Mortality-3 (PRISM-3), Pediatric Trauma Score (PTS), and Pediatric Glasgow Coma Score (pGCS) in determining clinical severity and mortality among critical pediatric trauma patients. A total of 122 patients monitored due to trauma in the pediatric intensive care unit between 2020 and 2023 were included in the study. Physical examination findings, vital parameters, laboratory values, and all scoring calculations for patients during emergency room admissions and on the first day of intensive care follow-up were recorded. Comparisons were made between two groups identified as survivors and non-survivors. The study included 85 (69.7%) male and 37 (30.3%) female patients, with an average age of 75 ± 59 months for all patients. Forty-one patients (33.6%) required Invasive Mechanical Ventilation (IMV) and 11 patients (9%) required inotropic therapy. Logistic regression analysis revealed a significant association between mortality and PEWS (p < 0.001), PRISM-3 (p < 0.001), PTS (p < 0.001), and pGCS (p < 0.001). Receiver operating characteristics curve analysis demonstrated that the PEWS score (cutoff > 6.5, AUC = 0.953, 95% CI 0.912-0.994) was highly predictive of mortality, showing similar performance to the PRISM-3 score (cutoff > 21, AUC = 0.999, 95% CI 0.995-1). Additionally, the PEWS score was found to be highly predictive in forecasting the need for IMV and inotropic therapy. The Pediatric Early Warning Score serves as a robust determinant of mortality in critical pediatric trauma patients. Simultaneously, it demonstrates strong predictability in anticipating the need for IMV and inotropic therapy.