New PELOD-2 cut-off score for predicting death in children with sepsis

Suari, Ni Made Rini; Latief, Abdul; Pudjiadi, Antonius Hocky

doi:10.14238/pi61.1.2021.39-45

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…16 With an individual cut-off, the diagnostic performance was similar among all three scores. This was also reported by Melda et al (2021) 14 and Suari et al (2021) 17 , who did not find any significant differences in the accuracy, sensitivity, specificity, positive predictive value, or negative predictive value in the PELOD-2 score with and without the lactate variable. This could be explained by the multivariable logistic regression analysis findings, which revealed that the blood lactate variable was not statistically significant (p-value=0.557).…”

Section: Diagnostic Performancesupporting

confidence: 84%

Comparing Pediatric Index of Mortality 3, Pediatric Logistic Organ Dysfunction 2 (PELOD-2), and Modified PELOD-2 scores for Mortality Prognosis in Vietnamese Children with Multiple Organ Dysfunction Syndrome

Nguyen

Phan

Vo-Pham-Minh

et al. 2022

J Health Sci Med Res

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Objective: To evaluate the performance of three scores, the Pediatric Index of Mortality 3 (PIM-3), the Pediatric Logistic Organ Dysfunction 2 (PELOD-2), and the modified PELOD-2 scores, in predicting mortality in multiple organ dysfunction syndrome (MODS) children in Vietnam.Material and Methods: This cross-sectional study of MODS children admitted to the pediatric intensive care unit (PICU) of a central children’s hospital in the Mekong Delta, Vietnam, was undertaken from April 2019 to June 2021. All three scores were evaluated using receiver operating characteristic (ROC) curves for discrimination and the Hosmer-Lemeshow goodness-of-fit test for calibration.Results: Of eighty-four subjects, the median age was 24.5 months and the overall mortality rate was 63.1%. ROC curve analysis showed that the area under the curve of PIM-3, PELOD-2, and modified PELOD-2 for predicting the death of MODS children were 0.77, 0.89, and 0.89, respectively. With individual cut-offs, the PIM-3, PELOD-2, and modified PELOD-2 scores had sensitivities for predicting mortality of 81.1%, 79.2%, and 81.1%, respectively, and specificities of 61.3%, 87.1%, and 80.6%, respectively. All three scores performed well in the Hosmer-Lemeshow goodness-of-fit test, indicating high calibration between predicted and observed mortalities (PIM-3: χ²=4.36, p-value=0.823; PELOD-2: χ²=4.837, p-value=0.775; modified PELOD-2: χ²=6.082, p-value=0.638).Conclusion: The PELOD-2 and modified PELOD-2 scores showed a better mortality prognosis than the PIM-3 score. Compared to the PELOD-2, the modified PELOD-2 with fewer parameters can still predict mortality well in Vietnamese children with MODS when using a cut-off score ≥9.

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Section: Diagnostic Performancesupporting

confidence: 84%

Comparing Pediatric Index of Mortality 3, Pediatric Logistic Organ Dysfunction 2 (PELOD-2), and Modified PELOD-2 scores for Mortality Prognosis in Vietnamese Children with Multiple Organ Dysfunction Syndrome

Nguyen

Phan

Vo-Pham-Minh

et al. 2022

J Health Sci Med Res

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“…The incidence of sepsis is influenced by age, underlying conditions, and infection source. 20,21 Children under five have immature immune systems, thus they are more likely to get serious infections or even sepsis. 22 In our study, respiratory illness was the primary disease leading to organ dysfunction in septic children.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil lymphocyte ratio and severity of acute kidney injury in septic children

Kowita,

Sovira,

Safri

et al. 2023

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Background Acute kidney injury (AKI) in sepsis is associated with an inflammatory process in kidney microcirculation and may increase morbidity and mortality in children. The neutrophil lymphocyte ratio (NLR) is an inflammatory biomarker of the inflammatory process in sepsis. Objective To determine the role of NLR in predicting the severity of AKI and to describe the demographic and laboratory characteristics, as they relate to outcomes of pediatric patients with AKI and sepsis. Methods This cross-sectional study was conducted in the PICU at Dr. Zainoel Abidin General Hospital (RSUDZA), Banda Aceh, Aceh. Medical record data were obtained from critically ill children with sepsis and AKI. Chi-square test was used to compare the proportions of each variable. We also calculated odds ratios to evaluate the AKI severity, PELOD-2 score, and patient outcomes. Spearman's analysis was used to look for a possible correlation between NLR and AKI severity in septic children. Results Seventy-one subjects with sepsis and AKI were included. Subject characteristics were as follows: 63.4% males, 63.4% < 1 year of age, 56.3% with respiratory problems as a primary disease, 38% with AKI injury stage, and 54.9% subjects with PELOD-2 score ?10. There was no significant correlation between AKI severity and mortality (OR 3.04; 95%CI 0.990 to 9.378; P=0.052). Subjects with a PELOD-2 score ?10 had a 47.6 times higher chance of mortality in septic children with AKI compared to those with PELOD-2 scores <10. There was no correlation between NLR and AKI severity (r=0.019; P=0.878). Conclusion There is no correlation between NLR and AKI severity. Sepsis accompanied by AKI may increase the risk of mortality in children. Septic children with more severe AKI tends to be less survive.

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Pediatric sepsis profile in a tertiary-care hospital in Indonesia: a 4-year retrospective study

Pudjiadi,

Putri,

Wijaya

et al. 2023

Journal of Tropical Pediatrics

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Aim This study aimed to explore the factors contributing to mortality and its management among pediatric sepsis patients at a single center in Indonesia. Method We conducted a retrospective study of children admitted due to sepsis from January 2015 to December 2019 in an Indonesian tertiary hospital. Results The mortality rate of pediatric sepsis in our study was 76.1% among 176 records with outcome identified. Mortality was significantly associated with septic shock at triage, number of organ failure, intensive care unit admission, inotropic use, septic shock and severe sepsis during hospitalization. Timing of antibiotic use did not affect mortality. Death within the first 24 h occurred in 41.8% of subjects, mostly due to septic shock. Conclusion This study illuminates the current state of pediatric sepsis management in our Indonesian hospital, revealing it as inadequate. Findings highlight the need for improved pre-hospital systems and sepsis recognition tools, and wider use of mechanical ventilators and advanced monitoring due to limited pediatric intensive care unit beds. Future research should focus on hospital-specific sepsis protocols to reduce pediatric sepsis mortality rates.

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New PELOD-2 cut-off score for predicting death in children with sepsis

Cited by 4 publications

References 20 publications

Comparing Pediatric Index of Mortality 3, Pediatric Logistic Organ Dysfunction 2 (PELOD-2), and Modified PELOD-2 scores for Mortality Prognosis in Vietnamese Children with Multiple Organ Dysfunction Syndrome

Comparing Pediatric Index of Mortality 3, Pediatric Logistic Organ Dysfunction 2 (PELOD-2), and Modified PELOD-2 scores for Mortality Prognosis in Vietnamese Children with Multiple Organ Dysfunction Syndrome

Neutrophil lymphocyte ratio and severity of acute kidney injury in septic children

Pediatric sepsis profile in a tertiary-care hospital in Indonesia: a 4-year retrospective study

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