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Assessing the outcome of pediatric intensive care
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Insights
The Pediatric Overall Performance Category (POPC) and Pediatric Cerebral Performance Category (PCPC) scales effectively assess pediatric intensive care outcomes. These reliable tools correlate with morbidity and severity, aiding in patient evaluation.
Area of Science:
- Pediatric Intensive Care
- Clinical Outcomes Assessment
- Neurodevelopmental Pediatrics
Background:
- Assessing short-term outcomes in pediatric intensive care is crucial for patient management.
- Quantifying functional morbidity and cognitive impairment requires validated tools.
Purpose of the Study:
- To develop and validate the Pediatric Overall Performance Category (POPC) and Pediatric Cerebral Performance Category (PCPC) scales.
- To evaluate the short-term outcomes of pediatric intensive care admissions.
Main Methods:
- Developed POPC and PCPC scales for functional and cognitive assessment.
- Collected data from 1469 subjects (1539 admissions) at a pediatric intensive care unit.
- Calculated delta scores (discharge minus baseline) and analyzed correlations with morbidity and severity measures.
Main Results:
- POPC and PCPC scales demonstrated excellent interrater reliability (r=0.88-0.96).
- Changes in POPC and PCPC scores significantly correlated with length of stay, hospital charges, discharge needs, and severity scores (p<0.0001).
Conclusions:
- The POPC and PCPC scales are reliable and valid instruments for assessing pediatric intensive care outcomes.
- These scales aid in quantifying functional morbidity and cognitive impairment in critically ill children.
Abstract:
To describe the short-term outcome of pediatric intensive care by quantifying overall functional morbidity and cognitive impairment, I developed the Pediatric Overall Performance Category (POPC) and the Pediatric Cerebral Performance Category (PCPC) scales, respectively. A total of 1469 subjects (1539 admissions) were admitted to the pediatric intensive care unit of Arkansas Children's Hospital from July 1989 through December 1990. Patients were assigned baseline POPC and PCPC scores derived from historical information and discharge scores at the time of discharge from the hospital (or from the pediatric intensive care unit for patients with multiple hospitalizations). Delta scores were calculated as the difference between the discharge scores and the baseline scores. The changes in POPC and PCPC scores were associated with several measures of morbidity (length of stay in the pediatric intensive care unit, total hospital charges, and discharge care needs) and with severity of illness (pediatric risk of mortality score) or severity of injury (pediatric trauma score) (p less than 0.0001). Interrater reliability was excellent (r = 0.88 to 0.96; p less than 0.001). The POPC and PCPC scales are apparently reliable and valid tools for assessing the outcome of pediatric intensive care.