Evaluation of modified paediatric logistic organ dysfunction scoring system in predicting the outcome in critically ill children

Authors

  • John P. George Department of Paediatrics, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India
  • Aparna Namboodiripad Department of Paediatrics, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20181506

Keywords:

Multiple organ dysfunction syndrome, Pediatrics logistic organ dysfunction, Respiratory failure, Sepsis

Abstract

Background: The Pediatric Logistic Organ Dysfunction (PELOD) score has been earlier validated for scoring of children in the Pediatric Intensive Care Unit (PICU). We have modified the PELOD score to adapt to resource limited settings by replacing Partial pressure of Oxygen (PaO2) / Fraction of inspired oxygen (FiO2)ratio, Partial pressure of carbon dioxide (PaCO2), and mechanical ventilation by three new variables i.e. Respiratory rate, Chest retraction and Peripheral Capillary Oxygen Saturation (SpO2). Aim of this study was to assess the 'Modified PELOD' scoring system and correlate it with the prognosis of children in the PICU.

Methods: A prospective, observational, hospital-based study on 75 critically ill patients admitted in the PICU from age one month to 15 years was done, during a period of one year, from June 2015 to May 2016. The modified PELOD scoring system was calculated for the patients during the first 24 hours of admission. Patients were followed up until they got discharged from the PICU or died.

Results: Modified PELOD scores ranged from 1- 42 in this study, of which patients with higher values had worst prognosis. Modified PELOD score ≥23 had increased risk of mortality.

Conclusions: The Modified PELOD score can be used to predict outcome even in resource limited settings. The mortality rate increases with increase in number of organs having dysfunction. Length of stay less than 48 hours is critical in terms of monitoring and management, as the chances of mortality are high during this period.

References

Gulla KM, Sachdev A. Illness severity and organ dysfunction scoring in Pediatric Intensive Care Unit. Ind J Crit Care Med. 2016;20:27.

Leteurtre S, Martinot A, Duhamel A, Gauvin F, Grandbastien B, Nam TV, Proulx F, Lacroix J, Leclerc F. Development of a pediatric multiple organ dysfunction score: use of two strategies. Med Decis Making. 1999;19:399-410.

Leteurtre S, Martinot A, Duhamel A, Proulx F, Grandbastien B, Cotting J, Gottesman R, et al. Validation of the paediatric logistic organ dysfunction (PELOD) score: prospective, observational, multicentre study. Lancet. 2003;362:192-7.

Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638-52.

Hendra H, Runtunuwu AL, Manoppo JI. Pediatric logistic organ dysfunction (PELOD) score as prognosis of multiple organ failure in sepsis. Pediat Indones. 2010;50:226-31.

Thukral A, Kohli U, Lodha R, Kabra SK, Arora NK. Validation of the PELOD score for multiple organ dysfunction in children. Ind Pediat. 2007;44:683.

Gaur A, Ambey R, Sharma A. Modified pediatric logistic organ dysfunction scoring system: A feasible tool in pediatric intensive care units. Int J Med Sci Res Prac. 2015;2:32-6.

Metta D, Soebardja D, Hudaya D. The use of pediatric logistic organ dysfunction (PELOD) scoring system to determine the prognosis of patients in pediatric intensive care units. Pediat Indones. 2016;46:1-6.

Honna L, Triratna S, Triwani T, Theodorus T. Use of paediatric logistic organ dysfunction in determining prognostic among paediatric intensive care unit patients. Pediat Indones. 2016;50:347-50.

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Published

2018-04-20

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Section

Original Research Articles