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99 PELOD-2: An Update of the Pediatric Logistic Organ Dysfunction Score
  1. S Leteurtre1,2,
  2. A Duhamel2,3,
  3. J Salleron2,3,
  4. B Grandbastien2,4,
  5. J Lacroix5,
  6. F Leclerc1,2 on behalf of the Groupe Francophone de Réanimation et d’Urgences Pédiatriques (GFRUP)
  1. 1Pediatric Intensive Care Unit, Jeanne de Flandre University Hospital
  2. 2EA2694, Univ Lille Nord de France, UDSL
  3. 3Department of Biostatistics, CERIM, University of Medicine
  4. 4Department of Epidemiology and Public Health, Calmette Hospital, Lille, France
  5. 5Pediatric Intensive Care Unit, Sainte-Justine Hospital, Université de Montréal, Montréal, QC, Canada

Abstract

Background and aims Organ dysfunction scores, such as the PEdiatric Logistic Organ Dysfunction (PELOD) score developed in 1999, are primarily designed to describe the severity of organ dysfunction. This study was undertaken to update and improve the PELOD score, using a larger and more recent dataset.

Methods We did a prospective, observational, multicentre cohort study in nine French-speaking multidisciplinary, tertiary-care PICUs of university-affiliated hospitals between June 2006 and October 2007. We collected data on variables considered for the PELOD-2 score at seven time-points after PICU admission: days 1, 2, 5, 8, 12, 16 and 18, plus PICU discharge. For each variable, the most abnormal value observed during each time point was collected. Identification of the best variable cutoffs was performed using bivariate, multivariate regressions and bootstrap process. The outcome was vital status at PICU discharge. We used area under receiver operating characteristic curve (AUC) to evaluate discrimination and Hosmer-Lemeshow goodness-of-fit test to evaluate calibration.

Results We included 3671 consecutive patients (median age 15.5 months IQR 2.2–70.7). Mortality rate was 6.0% (222 deaths). Discrimination and calibration of the PELOD 2 score were 0.93 and 9.31 (p=0.317) respectively.

Conclusion We developed and validated the PELOD-2 score, which allows assessment of the severity of cases of MODS in PICU with a continuous scale. The score will be in the public domain, which means that it can be freely used in clinical trials.

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