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Prevalence of multiple organ dysfunction in the pediatric intensive care unit: Pediatric Risk of Mortality III versus

Azza Abd Elkader El Hamshary1, Seham Awad El Sherbini2, HebatAllah Fadel Elgebaly2

  • 1Department of Pediatrics, Faculty of Medicine, Cairo University - Cairo, Egypt.

Revista Brasileira De Terapia Intensiva
|October 5, 2017
PubMed

Insights

Multiple organ dysfunction syndrome (MODS) is common in critically ill children, with sepsis being a primary cause. The Pediatric Risk of Mortality III (PRISM III) score better predicts outcomes than the Pediatric Logistic Organ Dysfunction (PELOD) score.

Area of Science:

  • Pediatric critical care medicine
  • Pediatric intensive care
  • Sepsis and organ dysfunction

Background:

  • Multiple organ dysfunction syndrome (MODS) is a significant concern in pediatric intensive care units (PICUs).
  • Sepsis is frequently implicated as a primary driver of MODS in critically ill children.
  • Accurate prognostic scoring systems are crucial for managing pediatric critical illness.

Purpose of the Study:

  • To determine the incidence of primary multiple organ failure in critically ill children.
  • To evaluate the role of sepsis in causing multiple organ dysfunction.
  • To compare the predictive accuracy of the Pediatric Risk of Mortality III (PRISM III) and Pediatric Logistic Organ Dysfunction (PELOD) scores for patient outcomes.

Main Methods:

  • A retrospective study was conducted on 237 patients admitted to a pediatric intensive care unit between January and December 2011.
  • Data on patient demographics, clinical conditions, and outcomes were analyzed.
  • The accuracy of PRISM III and PELOD scores in predicting mortality was assessed.

Main Results:

  • 72% of patients experienced multiple organ dysfunction, with 45% having sepsis-induced MODS.
  • The mortality rate for patients with MODS was high at 73%.
  • Mechanical ventilation and neurological failure were independent risk factors for death. PRISM III showed better calibration than PELOD, though PELOD had a higher area under the curve (0.78 vs. 0.723).

Conclusions:

  • Multiple organ dysfunction syndrome is associated with substantial mortality in critically ill children, often stemming from sepsis.
  • Pneumonia, diarrhea, and central nervous system infections were identified as leading causes of sepsis.
  • PRISM III demonstrated superior calibration for patient prognosis compared to PELOD.
Abstract

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