Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital

Abstract

A bstract Aims and objectives Utility of pediatric logistic organ dysfunction-2 (PELOD-2) score on day 1 within 1 hour of admission in predicting mortality in children admitted in pediatric intensive care unit (PICU). Background Various scoring systems aid to evaluate the patient's mortality risk in the intensive care unit (ICU) by assigning a score and predicting the outcome. Critically ill children are characterized by large variations in the normal body homeostasis. These variations can be estimated by the change of the physiological variables from the normal range. Various scores are constructed from deviations of these changed variables. One such score, the PELOD-2 score, is used to predict mortality of patients admitted in PICU. Materials and methods This study was carried out at a tertiary care center in central India to study the utility of PELOD-2 score within 1 hour of admission to predict mortality in patients admitted in PICU. Results Total 129 patients were included in this study with mean age of 67 months. The system with highest admission was central nervous system with 42 children and 16.6% mortality, whereas those 7 patients with hematological system involvement had highest mortality of 28.5%. The mortality rate was 15.55%. In our study for PELOD-2 within 24 hours of admission, the area under receiver operating curve was 0.87 and the Hosmer–Lemeshow test was p = 0.42. Conclusion Pediatric logistic organ dysfunction-2 score in our study had significant association with mortality along with the Hosmer–Lemeshow goodness-of-fit test showing a good prediction of mortality. How to cite this article Deshmukh T, Varma A, Damke S, Meshram R. Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital. Indian J Crit Care Med 2020;24(8):701–704.

Meta-Analysis for the Prediction of Mortality Rates in a Pediatric Intensive Care Unit Using Different Scores: PRISM-III/IV, PIM-3, and PELOD-2

“…The study by Karam et al ( 5 ) further showed the good calibration of the model, with a day 1 PELOD-2 AUC of 0.76 (95 CI 0.71–0.81) and Hosmer-Lemeshow test p = 0.76. Good Calibration and discrimination of PELOD-2 were also reported in the study by Deshmukh et al ( 34 ) (AUC = 0.93) and chi-square test for goodness of fit p = 0.45 in PICU patients with sepsis, further confirming the validity and reliability of the model.…”

“…A total of 29 studies were included for quantitative synthesis, among them, 18 studies that reported on the scoring systems PRISM-III/IV, ( 3 , 4 , 11 , 14 – 21 , 23 – 27 , 37 ), 11 studies that reported data on PIM-3 ( 3 , 4 , 7 , 14 , 16 , 18 , 20 , 28 – 31 ), and nine studies that reported data on PELOD-2 ( 5 , 14 , 16 , 28 , 32 – 36 ). Four studies were reported from India ( 4 , 7 , 17 , 34 ), two from Australia ( 20 , 32 ), two from China ( 20 , 32 ), two from Egypt ( 15 , 18 ), one from Pakistan ( 19 , 26 ), two from Korea ( 14 , 36 ), one from Mexico ( 21 ), one from Singapore ( 28 ), one from UAE ( 29 ), one from Indonesia ( 30 ), one from Africa ( 33 ), one from Saudi Arabia ( 11 ), two from Turkey ( 22 , 24 ), one from Sweden ( 23 ), one from Brazil ( 37 ), one from Switzerland ( 5 ), one from Thailand ( 27 ), one from Italy ( 31 ), and one multi-centric ( 25 ).…”

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“…The lower PELOD-2 score can partially explain the reduced mortality rate of the patients with MIS-C in our study. A study conducted in India found that a PELOD-2 score of 0–4 correlated with a 1.6% mortality rate, 5–9 correlated with a 14.8% mortality rate and 10–14 correlated with a 50% mortality rate [ 27 ]. In our study, of the two patients who passed away, Patient 1 had a PELOD- 2 score of 6 and Patient 9 had a PELOD-2 score of 9.…”

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“…Thereby, the nursing focuses can be determined, and the preventive measures can be taken in advance to minimize the pain and accidents of patients. It is a nursing method change from passive to active [20][21][22]. Compared with traditional nursing methods, predictive nursing is more systematic, comprehensive, and individualized and has more advantages [23].…”