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Multiple pediatric organ dysfunction scoring systems exist, but their performance varies widely. A need for unified, data-driven criteria for critically ill children is indicated.

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Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Assessment Tools
  • Biostatistics

Background:

  • Multiple scoring systems are available to assess organ dysfunction in children.
  • These scores aim to estimate illness severity in critically ill pediatric patients.

Purpose of the Study:

  • To review existing literature on multiple organ dysfunction (MOD) scoring systems in critically ill children.
  • To characterize the performance of these tools in assessing organ dysfunction and patient outcomes.

Main Methods:

  • Conducted electronic literature searches of PubMed and Embase (January 1992–January 2020).
  • Included studies evaluating critically ill children with MOD, assessing scoring tool performance, and analyzing patient outcomes.
  • Data abstraction performed by a task force member.

Main Results:

  • 54 eligible studies were identified from 1152 unique abstracts.
  • Commonly reported scores included Pediatric Logistic Organ Dysfunction (PELOD) and pediatric Sequential Organ Failure Assessment (pSOFA).
  • Significant variation was observed in criteria, diagnostic elements, and scoring methodologies.

Conclusions:

  • Scores generally showed increased mortality with greater organ dysfunction.
  • The performance characteristics of existing scores varied considerably.
  • There is a clear need for unified, data-driven organ dysfunction criteria validated in diverse international populations of critically ill children.