Predicting PICU patient survival prognosis: Pediatric Logistic Organ Dysfunction vs Pediatric Index of Mortality scores

  • Edwina Winiarti Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital, Semarang
  • Muhammad Sholeh Kosim Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital, Semarang
  • Mohammad Supriatna Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital, Semarang
Keywords: PELOD score, PIM score, prognosis, PICU

Abstract

Background Determining prognosis of patients using scoring
systems have been done in many pediatric intensive care units
(PICU). The scoring systems frequently used are pediatric logistic
organ dy sfunction (PELOD), pediatric index of mortality (PIM)
and pediatric risk of mortality (PRISM).
Objective To compare the performance of PELOD and PIM scores
in predicting the prognosis of survival vs death in PICU patients.
Methods A prognostic test in this prospective, cohort study was
conducted in the PICU of the Kariadi General Hospital, Semarang.
PELOD and PIM calculations were performed using formulae from
previously published articles. Statistical analyses included receiver
operating curve (ROC) characteristics to describe discrimination
capacity, sensitivity, specificity, positive predictive value, negative
predictive value and accuracy.
Results Thirty-three patients fulfilling the inclusion criteria were
enrolled in the study. PELOD score for area under the ROC
was 0.87 (95% CI 0.73 to 1.0; P=0.003), while that for PIM
was 0.65 (95% CI 0.39 to 0.90; P=0.2). PELOD scores showed
sensitivity 85.7% (95% CI 59.8 to 100), specificity 84.6% (95%
CI 70.7 to 98.5), positive predictive value 60.0% (95% CI 29.6
to 90.4) negative predictive value 95.6% (95% CI 87.3 to 100)
and accuracy 84.8%. PIM scores showed sensitivity 85.7% (95%
CI 59.8 to 100), specificity 50.0% (95% CI 30.8 to 69.2), positive
predictive value 31.6% (95% CI 10,7 to 52.5), negative predictive
value 92.9% (95% CI 79.4 to 100) and accuracy 57.6%.
Conclusion PELOD scoring had better specificity, positive predictive
value, negative predictive value, accuracy and discrimination capacity
than PIM scoring for predicting the survival prognosis of patients in
the PICU. [Paediatr Indones. 2012;52:165-9].

References

1. Leclerc F, Leteurtre S, Duhamel A, Grandbasrien B, P roulx
F, Martinot A. Cumulative influence of organ dysfunction
and septic state on mortality of critically ill child ren. Am J
Respir Crit Care Med. 2005;171:348-53,
2. Peres Bota D, MelotC, Lopes Ferreira F, Nguyen Ba V, Vincent
JL. The multiple organ dysfunction score (MODS) versus the
sequential organ failure assessment (SOFA) score in outcome
prediction. Intensive Care Med. 2002;28:1619-24.
3. Tantalean JA, Leon RJ, Santos AA- Sanchez E . Multiple
organ dysfunction syndrome in children. Pediatr Crit Care
Med.2003;4:181-5.
4. LacroixJ, Cotting J, for the Pediatric Acute Lung injury and
Sepsis Investigators (PALlSI) Nerwork. Severity of illness
and organ dysfunction scoring in children. Pediatr Crit Care
Med.2005;6:5126-34.
5. Proulx F􀁌 Fayon M 􀁌 Farrel CA􀁌 Lacroix J. Gauthier M.
Epidemiology of sepsis and multiple organ dysfunction
syndrome in children.C hest.1 996; 109: 1033-7.
6. Brilli RJ, Goldstein B. Pediatric sepsis definitions: past,
present, and future. Pediatr Crit Care Med. 2005;6:S6-8.
7. Qureshi AU, Ali AS, Ahmad TM. Comparison of three
prognostic scores (PRISM, PELOD and PIM 2) at pediatric
intensive care unit under Pakistani circumstances. J Ayub
Med Coli Abbottabad. 2007; 19:49-53.
8. Marlina L, Somasetia DH􀂙 Garna H. Perbandingan
penggunaan pediatric index of mortality 2 (PIM2) dan
skor pediatric logistic organ dysfunction (PELOD) untuk
memprediksi kematian pasien sakit rotis pada anak. Sari
Pediatri. 2008;10:262-7.
9. Leteurtre S. MartinotA. Duhamel A, Proulx F, Grandbastien
B. Cotting J. et at.V alidation of the paediatric logistic organ
dysfunction (PELOD) score: prospective, observational,
multicentre study. Lancet. 2003 ;362: 192-7.
10. Iskandar HR, Mulyo D, Agnes P, Suryatin Y. Comparison
of Pediatric Logistic Organ Dysfunction (PELOD) and
Pediatric Risk of Mortality (PRISM) III scores as a mortality
predictor in pediatric dengue shock syndrome (DSS) patients.
Pediatrics. 2008;121;129.
11. Mehta N, Castillo L. Nutrition in the critically ill child. In:Fuhrman BP, Zimmerman JJ, editors. Pediatric critical care.
yd ed. Philadelphia; Mosby Elsevier; 2006. p. 1068-83.
12. Han YY, Shanley TP. Multiple organ dysfunction syndrome.
In: Nichols DO, ed. Rogers' textbook of pediatric intensive
care. Philadelphia: Wolters Kluwer!Lippincott Williams &
Wilkins; 2008. p. 283-99.
Published
2012-06-30
How to Cite
1.
Winiarti E, Kosim M, Supriatna M. Predicting PICU patient survival prognosis: Pediatric Logistic Organ Dysfunction vs Pediatric Index of Mortality scores. PI [Internet]. 30Jun.2012 [cited 29Mar.2024];52(3):165-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/385
Section
Articles
Received 2016-08-30
Accepted 2016-08-30
Published 2012-06-30