دورية أكاديمية
Daily estimation of the severity of organ dysfunctions in critically ill children by using the pelod-2 score
| العنوان: | Daily estimation of the severity of organ dysfunctions in critically ill children by using the pelod-2 score |
|---|---|
| المؤلفون: | Leteurtre, Stephane, Duhamel, Alain, Deken, Valerie, Lacroix, Jacques, Leclerc, Francis |
| المساهمون: | Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire Lille (CHRU Lille), CHU Sainte Justine Montréal |
| المصدر: | ISSN: 1364-8535. |
| بيانات النشر: | HAL CCSD BioMed Central |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | MESH: Humans, MESH: Infant, MESH: Preschool, MESH: Critical Illness/classification, MESH: Female, MESH: Newborn, MESH: Intensive Care Units, MESH: Pediatric/statistics & numerical data, MESH: Male, MESH: Organ Dysfunction Scores, MESH: Prospective Studies, MESH: Severity of Illness Index, MESH: Child, [SDV]Life Sciences [q-bio], socio, musiq |
| الوصف: | International audience ; BACKGROUND: Daily or serial evaluation of multiple organ dysfunction syndrome (MODS) scores may provide useful information. We aimed to validate the daily (d) PELOD-2 score using the set of seven days proposed with the previous version of the score.METHODS: In all consecutive patients admitted to nine pediatric intensive care units (PICUs) we prospectively measured the dPELOD-2 score at day 1, 2, 5, 8, 12, 16, and 18. PICU mortality was used as the outcome dependent variable. The discriminant power of the dPELOD-2 scores was estimated using the area under the ROC curve and the calibration using the Hosmer-Lemeshow chi-square test. We used a logistic regression to investigate the relationship between the dPELOD-2 scores and outcome, and between the change in PELOD-2 score from day 1 and outcome.RESULTS: We included 3669 patients (median age 15.5 months, mortality rate 6.1%, median length of PICU stay 3 days). Median dPELOD-2 scores were significantly higher in nonsurvivors than in survivors (p < 0.0001). The dPELOD-2 score was available at least at day 2 in 2057 patients: among the 796 patients without MODS on day 1, 186 (23.3%) acquired the syndrome during their PICU stay (mortality 4.9% vs. 0.3% among the 610 who did not; p < 0.0001). Among the 1261 patients with MODS on day 1, the syndrome worsened in 157 (12.4%) and remained unchanged or improved in 1104 (87.6%) (mortality 22.9% vs. 6.6%; p < 0.0001). The AUC of the dPELOD-2 scores ranged from 0.75 (95% CI: 0.67-0.83) to 0.89 (95% CI: 0.86-0.91). The calibration was good with a chi-square test between 13.5 (p = 0.06) and 0.9 (p = 0.99). The PELOD-2 score on day 1 was a significant prognostic factor; the serial evaluation of the change in the dPELOD-2 score from day1, adjusted for baseline value, demonstrated a significant odds ratio of death for each of the 7 days.CONCLUSIONS: This study suggests that the progression of the severity of organ dysfunctions can be evaluated by measuring the dPELOD-2 score during a set of 7 days . |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://hal.univ-lille.fr/hal-02527545/file/s13054-015-1054-y.pdfTest; https://hal.univ-lille.fr/hal-02527545Test |
| الإتاحة: | https://doi.org/10.1186/s13054-015-1054-yTest https://hal.univ-lille.fr/hal-02527545/file/s13054-015-1054-y.pdfTest https://hal.univ-lille.fr/hal-02527545Test |
| حقوق: | undefined |
| رقم الانضمام: | edsbas.6DF3F677 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |