Predicting mortality in pediatric intensive care unit using pediatric logistic organ dysfunction score in a tertiary care centre

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ORIGINAL ARTICLE

Year : March 2013 | Volume : 10 | Issue : 3

DOI : 10.7199/ped.oncall.2013.19

PREDICTING MORTALITY IN PEDIATRIC INTENSIVE CARE UNIT USING PEDIATRIC LOGISTIC ORGAN DYSFUNCTION SCORE IN A TERTIARY CARE CENTRE

Jyotirmanju CS, Sunil kumar BM, Prarthana Karumbaiah, ATK Rau
Department of Pediatrics, M S Ramaiah Medical College, Bangalore. India.

Abstract

Aim: To predict mortality rate in children with multiple organ dysfunction (MODS) admitted to Pediatric Intensive Care Unit (PICU), using an externally validated score pediatric logistic organ dysfunction score (PELOD).

Design and Setting: Longitudinal observational study in a tertiary care medical college centre.

Methods: The study was conducted in 328 children (177 boys and 151 girls) in the age group of 1month to 14yrs admitted in the PICU. Data on the variables of PLEOD score, such as pulse rate, blood pressure, Glasgow coma scale (GCS), pupils were recorded on day 1. Hematological investigations [total count, platelet count, prothrombin time (PT), partial thromboplastin time (APTT), creatinine, ALT, and arterial blood gases) were done by standard laboratory techniques. Patients were followed up during the hospital stay and the outcome measures were recorded as died or survived at the end of the hospital stay. To calculate the PELOD score, each organ system received points for the single variable associated with the most points. The maximum number of points for an organ system is 4, and the maximum possible PLEOD score is 28.

Results: Overall mortality rate was 40 (12.2%). The odds ratio for mortality for four and more than four organ dysfunction was found to be 265.57 as compared to less than four organ dysfunction (p=0.001). The odds ratio for mortality with PELOD score of >20 was 3.5 (95% CI 1.54 to 8.01) as compared to the score less than 20. The differences in the mortality of the children whose score was less than 20 compared to more than 20 [30 (10.2%) vs 10 (28.6%)] was found to be statistically significant (p=0.002).

Conclusion: Mortality rate and the PELOD score increased with the number of organ dysfunction. PELOD score is definitely a good predictor of mortality, but it underscores morbidity.