Authors:

Abstract

Background: Scoring systems in an intensive care unit (ICU) help in monitoring the patient, evaluating the performance of the ICU and in determining the prognosis of the patient. Pediatric Logistic Organ Dysfunction-2 (PELOD-2) is a new scoring system describing organ dysfunction in paediatric intensive care unit (PICU) which has gained importance as a mortality predictor.

Objectives: To assess the performance of PELOD-2 in predicting mortality and compare it with Pediatric Risk of Mortality-III (PRISM-III) scoring system.

Method: This prospective observational study was carried out in a tertiary care PICU. All consecutive patients with critical illness were scored according to the 2 scoring systems within 24 hours of admission and followed up until discharge or death. Patients admitted for post-surgical care, PICU stay less than 2 hours, death within 8 hours of admission and patients leaving against medical advice were excluded from the study.

Results: A total of 550 patients with critical illness was included in study with a median (IQR) age of 60 (12,132) months and a M: F ratio of 1.6. Predicted mortality using PELOD-2 and PRISM-III score was 62 and 63 patients respectively whereas actual mortality was 67 patients. Area under the ROC was 0.992 for PELOD-2 and 0.98 for PRISM-III with a mean difference of 0.0118 with 95% CI (0.00325 to 0.0204) p value of 0.007. Hosmer and Lemeshow goodness of fit test also showed good calibration in predicting mortality for both scoring systems (PELOD-2: ꭓ² = 6.051, p value of 0.301, PRISM-III - ꭓ² = 9.391, p value= 0.153)

Conclusions: PRISM-III and PELOD-2 were found to have excellent discrimination and good calibration in our study.

Sri Lanka Journal of Child Health, 2023; 52(1): 45-51

Keywords: Critical illness, Paediatric intensive care, PELOD-2, PRISM-III