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

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...

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Bibliographic Details
Published in:The Lancet (British edition) 2003-07, Vol.362 (9379), p.192-197
Main Authors: Leteurtre, Stéphane, Martinot, Alain, Duhamel, Alain, Proulx, François, Grandbastien, Bruno, Cotting, Jacques, Gottesman, Ronald, Joffe, Ari, Pfenninger, Jurg, Hubert, Philippe, Lacroix, Jacques, Leclerc, Francis
Format: Article
Language:English
Subjects:
Adolescent
Calibration
Child
Child, Preschool
Children
Children & youth
Clinical trials
Critical care
Discrimination
Female
Glasgow Coma Scale
Goodness of fit
Heart rate
Hematology
Hospital Mortality
Hospitals
Humans
Infant
Infant, Newborn
Intensive care
Intensive care units
Intensive Care Units, Pediatric - statistics & numerical data
Logistic Models
Male
Mathematical models
Medical disorders
Medical Records, Problem-Oriented - statistics & numerical data
Medical research
Mortality
Multiple organ dysfunction syndrome
Multiple Organ Failure - classification
Multiple Organ Failure - diagnosis
Multiple Organ Failure - mortality
Outcome Assessment (Health Care) - methods
Outcome Assessment (Health Care) - statistics & numerical data
Patients
Pediatrics
Physical Examination - statistics & numerical data
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Statistical tests
Validity
Variables
Ventilators
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Summary: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). 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. 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
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(03)13908-6