A Junger

AJ Petros

Alain Duhamel

AM Ferreira

CJ Doig

DA Zygun

DP Wagner

E Sevketoglu

F Leclerc

F Proulx

FL Ferreira

Francis Leclerc

J Johnston

J Lacroix

J Tantalean

Jacques Lacroix

JC Marshall

JD Wilkinson

JF Timsit

JL Vincent

JP Burns

M Darmon

M Sandri

P Cengiz

PG Metnitz

R Cook

R Moreno

R Rivera-Fernandez

RB Thandassery

S Jacobs

S Leteurtre

SB Cappi

SL Weiss

Stéphane Leteurtre

TC Nguyen

VA Ferraris

Valérie Deken

YA Kilic

Abstract
                Introduction
                Daily or serial evaluation of multiple organ dysfunction syndrome (MODS) scores may provide useful information. We aimed to validate the daily (d) PELOD-2 score using the set of seven days proposed with the previous version of the score.
              
                Methods
                In all consecutive patients admitted to nine pediatric intensive care units (PICUs) we prospectively measured the dPELOD-2 score at day 1, 2, 5, 8, 12, 16, and 18. PICU mortality was used as the outcome dependent variable. The discriminant power of the dPELOD-2 scores was estimated using the area under the ROC curve and the calibration using the Hosmer-Lemeshow chi-square test. We used a logistic regression to investigate the relationship between the dPELOD-2 scores and outcome, and between the change in PELOD-2 score from day1 and outcome.
              
                Results
                We included 3669 patients (median age 15.5 months, mortality rate 6.1 %, median length of PICU stay 3 days). Median dPELOD-2 scores were significantly higher in nonsurvivors than in survivors (p &lt; 0.0001). The dPELOD-2 score was available at least at day 2 in 2057 patients: among the 796 patients without MODS on day1, 186 (23.3 %) acquired the syndrome during their PICU stay (mortality 4.9 % vs. 0.3 % among the 610 who did not; p &lt; 0.0001). Among the1261 patients with MODS on day1, the syndrome worsened in 157 (12.4 %) and remained unchanged or improved in 1104 (87.6 %) (mortality 22.9 % vs. 6.6 %; p &lt; 0.0001). The AUC of the dPELOD-2 scores ranged from 0.75 (95 % CI: 0.67-0.83) to 0.89 (95 % CI: 0.86-0.91). The calibration was good with a chi-square test between 13.5 (p = 0.06) and 0.9 (p = 0.99). The PELOD-2 score on day1 was a significant prognostic factor; the serial evaluation of the change in the dPELOD-2 score from day1, adjusted for baseline value, demonstrated a significant odds ratio of death for each of the 7 days.
              
                Conclusion
                This study suggests that the progression of the severity of organ dysfunctions can be evaluated by measuring the dPELOD-2 score during a set of 7 days in PICU, providing useful information on outcome in critically ill children. Its external validation would be useful.
              </jats:sec

null null

Crossref

Critical Care

Daily estimation of the severity of organ dysfunctions in critically ill children by using the PELOD-2 score

https://ccforum.biomedcentral.com/track/pdf/10.1186/s13054-015-1054-y?site=ccforum.biomedcentral.com

Daily estimation of the severity of organ dysfunctions in critically ill children by using the PELOD-2 score

Abstract

Similar works

Full text

Available Versions

Crossref