The use of pediatric logistic organ dysfunction (PELOD) scoring system to determine the prognosis of patients in pediatric intensive care units
Keywords:
PELOD score, prognosis, PICU
Abstract
Background Prediction of outcome of patients admitted to pediat-ric intensive care unit (PICU) requires an objective tool for measure-
ment. It is important to provide information for the patient’s family
and to explain the objectives of intensive care.
Objective To evaluate whether the Pediatric Logistic Organ Dys-
function (PELOD) scoring system can be used to determine the prog-
nosis of patients treated in PICU.
Methods A longitudinal-observational study on patients treated in
the PICU of Hasan Sadikin General Hospital was conducted in No-
vember 2004-December 2004. The PELOD scoring system was
applied to all subjects within the first 24 hours of PICU admission.
The scoring system consists of physical and laboratory variables of
6 organs, namely neurological, cardiovascular, renal, respiratory,
hematological, and hepatic systems. The sum of scores were ana-
lyzed by logistic regression method to calculate the probability of
death. The subjects were monitored until they passed away or were
discharged from PICU.
Results There were 32 subjects who met the inclusion criteria. The
mean (SD) of PELOD scores in survivors was 13.5 (8.5) and in non
survivors was 22.2 (10.1) (Z M-W =-2.507;P=0.012), while the mean
of PELOD scores in survivors of PELOD scores validation study
was 31.0, and in non survivors was 9.4. The increase of PELOD
scores correlated with the increase in the probability of death
(P=0.038), and a linear regression chart showed a positive correla-
tion (R 2 =0.93). PELOD scores at a 50% probability of death was 20,
while the mean PELOD scores validation study was 26. Based on
the probability of death of P<0.5, the death prediction and observed
death had a sensitivity of 54.5% and a specificity of 80.9%. Among
patients with high PELOD scores (>20) and those with low PELOD
scores (<20), the number of patients who survived with extended
length of stay in PICU, were not significantly different (P=0.15).
Conclusions PELOD scoring system can be used to determine the
patient’s probability of death in PICU, but can not be used to predict
the length of stay in PICU
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tors. Textbook of pediatric critical care. Philadelphia:
WB Saunders Company; 1993. p. 1151-9.
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care in Kuala Lumpur, Malaysia: A developing subspe-
cialty. J Trop Pediatr 1999;45:362-4.
tem. Br Med J 1999;319:241-4.
2. Marcin JP, Pollack MM, Patel KM, Sprague BM,
Ruttimann UE. Prognostication and certainty in the pae-
diatric intensive care unit. Pediatrics 1999;104:868-73.
3. Fiser DH. Assessing the outcome of pediatric inten-
sive care. J Pediatr 1992;121:68-74.
4. Tan GH, Tan TH, Goh DYT, Yap HK. Risk factors for
predicting mortality in a paediatric intensive care unit.
Ann Acad Med Singapore 1998;27:813-8.
5. Rocker G, Cook D, Sjokvist P, Weaver B, Finfer S,
McDonald E, et al. Clinician prediction of intensive
care unit mortality. Crit Care Med 2004;32:1149-54.
6. Seneff MG, Zimmerman JE, Knaus WA. Severity of illness
indices and outcome prediction: Development and evalu-
ation. In: Ayres SM, Grenvick A, Holbrook PR, Shoemaker
WC, editors. Textbook of critical care; 3rd ed. Philadel-
phia: WB Saunders Company; 1995. p. 1777-88.
7. Lemeshow S, Le Gall JR. Modelling the severity of ill-
ness of ICU patients. A systems update. JAMA 1994;
272:1049-55.
8. Petilla V, Petilla M, Sarna S, Voutilainen P, Takkunen
O. Comparison of multiple organ dysfunction scores
in the predicting of hospital mortality in the critically
ill. Crit Care Med 2002;30:1913-4.
9. Leteurtre S, Martinot A, Duhamel A, Proulx F,
Grandbastien B, Cotting J, et al. Validation of the pae-
diatric logistic organ dysfunction (PELOD) score: Pro-
spective, observational, multicentre study. Lancet
2003;362:192-7.
10. Safitri H. Sengketa medik, alternatif penyelesaian
perselisihan antara dokter dengan pasien. Jakarta:
Diadit Media; 2005. p. 57-82.
11. Pollack MM. Outcome analysis. In: Holbrook PR, edi-
tors. Textbook of pediatric critical care. Philadelphia:
WB Saunders Company; 1993. p. 1151-9.
12. Goh AYT, Lum LCS, Chan PWK. Paediatric intensive
care in Kuala Lumpur, Malaysia: A developing subspe-
cialty. J Trop Pediatr 1999;45:362-4.
Published
2016-10-18
How to Cite
1.
Metta D, Soebardja D, S D. The use of pediatric logistic organ dysfunction (PELOD) scoring system to determine the prognosis of patients in pediatric intensive care units. PI [Internet]. 18Oct.2016 [cited 26Apr.2024];46(1):1-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/846
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Received 2016-10-10
Accepted 2016-10-10
Published 2016-10-18
Accepted 2016-10-10
Published 2016-10-18
