Validation of PELOD-2 score as a predictor of life-threatening organ dysfunction in pediatric sepsis

  • Yuyun Romaria Simanjuntak
  • Indra Saputra
  • Silvia Triratna
  • Achirul Bakri
  • Yulia Iriani Department of Child Health, Medical School, Sriwijaya University
Keywords: PELOD-2 score, pediatric sepsis


Background The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction due to immune dysregulation against infection. It recommends the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score to evaluate life-threatening organ dysfunction. But the SOFA tool has not been adjusted for pediatric patients.  The Indonesian Pediatrics Society (IPS) uses the same sepsis definition and recommends using the PELOD-2 score as an indicator of life-threatening organ dysfunction in children.    

Objective To evaluate the validity of the PELOD-2 score for predicting life-threatening organ dysfunction in pediatric sepsis.

Methods A prospective cohort study was conducted in children with sepsis who were admitted to the PICU.  Subjects were taken consecutively with inclusion criteria of 1 month-18 years of age, with organ dysfunction, having two or more symptoms of systemic inflammatory response syndrome (SIRS), and suspected or proven infection.  PELOD-2 score, with and without lactate result, of each subject were plotted to receiver operating characteristic (ROC) curve, then we determined the most optimal cut off point to predict the life-threathneing organ dysfunction in pediatric sepsis based on the sensitivity and specificity of each score.

Results Sixty-six patients were analyzed, with 40 males and 26 females aged 2 to 183 months (median 11 months).  Twenty patients died while in the PICU. A PELOD-2 score (with lactate) cut-off ≥ 7 was determined by ROC curve, with sensitivity of 80% and specificity of 78%. The area under the curve (AUC) of PELOD-2 score (with lactate) was 84.8% (95%CI 74.7 to 95.9%).  A PELOD-2 score (without lactate) ≥ 7  was the most optimum cut off based on its Youden index, it haD 70% of sensitivity and 80% of specificity.

Conclusion PELOD-2 score ≥ 7 , with or without lactate component is the optimal cut-off for predicting life-threatening organ dysfunction in pediatric sepsis. 


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How to Cite
Simanjuntak Y, Saputra I, Triratna S, Bakri A, Iriani Y. Validation of PELOD-2 score as a predictor of life-threatening organ dysfunction in pediatric sepsis. PI [Internet]. 7Jul.2020 [cited 16Jun.2024];60(5):227-. Available from:
Emergency & Pediatric Intensive Care
Received 2019-12-25
Accepted 2020-07-07
Published 2020-07-07