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Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Stéphane Leteurtre1, Alain Duhamel, Bruno Grandbastien

  • 1Pediatric Intensive Care Unit, the Department of Biostatistics, Université Lille Nord de France, UDSL, EA 2694, Centre hospitalier universitaire Lille, Lille, France.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|June 16, 2010
PubMed

Insights

Tracking Pediatric Logistic Organ Dysfunction (PELOD) scores daily in critically ill children helps predict mortality. Specific measurement days offer optimal insights into disease progression.

Area of Science:

  • Pediatric critical care medicine
  • Clinical scoring systems
  • Multiorgan dysfunction syndrome (MODS)

Background:

  • Daily assessment of MODS is standard in adult critical care.
  • The Pediatric Logistic Organ Dysfunction (PELOD) score evaluates critically ill children.
  • This study aimed to assess PELOD score changes over time and identify optimal measurement days.

Purpose of the Study:

  • To evaluate the clinical course of MODS in critically ill children using the PELOD score.
  • To determine the optimal days for measuring PELOD scores to predict mortality.
  • To analyze the relationship between PELOD score changes and PICU mortality.

Main Methods:

  • Prospective study of 1806 children in seven PICUs.
  • Daily PELOD scores were recorded and changes over time analyzed.
  • Cox survival analyses were used to identify optimal measurement days.

Main Results:

  • Overall PICU mortality was 6.4%.
  • High initial PELOD scores (≥20) on day 1 significantly increased mortality risk (OR 40.7).
  • A specific set of seven days (1, 2, 5, 8, 12, 16, 18) was identified as optimal for PELOD score measurement.

Conclusions:

  • Worsening or static PELOD scores indicate poor prognosis in critically ill children.
  • Using a seven-day measurement schedule for PELOD scores provides optimal information on MODS progression.
  • This approach aids in predicting outcomes for critically ill children.
Abstract

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