Validation of the paediatric logistic organ dysfunction (PELOD) score: prospective, observational, multicentre study

Détails

ID Serval
serval:BIB_D338C060185C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Validation of the paediatric logistic organ dysfunction (PELOD) score: prospective, observational, multicentre study
Périodique
Lancet
Auteur(s)
Leteurtre  S., Martinot  A., Duhamel  A., Proulx  F., Grandbastien  B., Cotting  J., Gottesman  R., Joffe  A., Pfenninger  J., Hubert  P., Lacroix  J., Leclerc  F.
ISSN
1474-547X (Electronic)
Statut éditorial
Publié
Date de publication
07/2003
Volume
362
Numéro
9379
Pages
192-7
Notes
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Jul 19
Résumé
BACKGROUND: Multiple organ dysfunction syndrome is more frequent than death in paediatric intensive care units. Estimation of the severity of this syndrome could be a useful additional outcome measure in clinical trials in such units. We aimed to validate the paediatric logistic organ dysfunction (PELOD) score and estimate its validity when recorded daily (dPELOD). METHODS: We did a prospective, observational, multicentre cohort study in seven multidisciplinary, tertiary-care paediatric intensive care units of university-affiliated hospitals (two French, three Canadian, and two Swiss). We included 1806 consecutive patients (median age 24 months; IQR 5-90). PELOD score includes six organ dysfunctions and 12 variables and was recorded daily. For each variable, the most abnormal value each day and during the whole stay were used in calculating the dPELOD and PELOD scores, respectively. Outcome was vital status at discharge. We used Hosmer-Lemeshow goodness-of-fit tests to evaluate calibration and areas under receiver operating characteristic curve (AUC) to estimate discrimination. FINDINGS: 370 (21%) patients had no organ dysfunction, 471 (26%) had one, 457 (25%) had two, and 508 (28%) had three or more. Case fatality rate was 6.4% (115 deaths). PELOD score was significantly higher in non-survivors (mean 31.0 [SE 1.2]) than survivors (9.4 [0.2]; p<0.0001). Calibration (p=0.54) and discrimination (AUC=0.91, SE=0.01) of PELOD and dPELOD (p> or =0.39; AUC> or =0.79) scores were good. INTERPRETATION: PELOD and dPELOD scores are valid outcome measures of the severity of multiple organ dysfunction syndrome in paediatric intensive care units; their use should significantly reduce the sample size required to complete clinical trials in critically ill children.
Mots-clé
Adolescent Child Child, Preschool Female Glasgow Coma Scale Hospital Mortality Humans Infant Infant, Newborn Intensive Care Units, Pediatric/*statistics & numerical data Logistic Models Male Medical Records, Problem-Oriented/statistics & numerical data Multiple Organ Failure/*classification/diagnosis/mortality Outcome Assessment (Health Care)/methods/statistics & numerical data Physical Examination/statistics & numerical data Prospective Studies Reproducibility of Results Severity of Illness Index
Pubmed
Web of science
Création de la notice
24/01/2008 16:41
Dernière modification de la notice
20/08/2019 15:53
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