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      Day-1 PELOD-2 and day-1 "quick" PELOD-2 scores in children with sepsis in the PICU Translated title: Desempenhos dos escores PELOD-2 no dia 1 e ‘‘quick'' PELOD-2 no dia 1 em crianças com sepse na UTIP

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          Abstract Objectives: This study aimed to evaluate the predictive validity of the day-1 PELOD-2 and day-1 "quick" PELOD-2 (qPELOD-2) scores for in-hospital mortality in children with sepsis in a pediatric intensive care unit (PICU) of a developing country. Methods: The data of 516 children diagnosed as sepsis were retrospectively analyzed. The children were divided into survival group and non-survival group, according to the clinical outcome 28 days after admission. Day-1 PELOD-2, day-1 qPELOD-2, pediatric SOFA (pSOFA), and P-MODS were collected and scored. Receiver operating characteristic (ROC) curves were plotted, and the efficiency of the day-1 PELOD-2, day-1 qPELOD-2 score, pSOFA, and P-MODS for predicting death were evaluated by the area under the ROC curve (AUC). Results: The day-1 PELOD-2 score, day-1 qPELOD-2 score, pSOFA, and P-MODS in the non-survivor group were significantly higher than those in the survivor group. ROC curve analysis showed that the AUCs of the day-1 PELOD-2 score, day-1 qPELOD-2 score, pSOFA, and P-MODS for predicting the prognosis of children with sepsis in the PICU were 0.916, 0.802, 0.937, and 0.761, respectively (all p < 0.05). Conclusions: Both the day-1 PELOD-2 score and day-1 qPELOD-2 score were effective and able to assess the prognosis of children with sepsis in a PICU of a developing country. Additionally, the day-1 PELOD-2 score was superior to the day-1 qPELOD-2 score. Further studies are needed to verify the usefulness of the day-1 qPELOD-2 score, particularly outside of the PICU.

          Translated abstract

          Resumo Objetivos: A finalidade de nosso estudo foi avaliar a validade preditiva dos escores PELOD-2 no dia 1 e "quick" PELOD-2 no dia 1 com relação à mortalidade hospitalar em crianças com sepse em uma UTIP de um país em desenvolvimento. Métodos: Foram analisados retrospectivamente os dados de 516 crianças diagnosticadas com sepse. As crianças foram divididas em grupo sobrevida e grupo não sobrevida de acordo com o desfecho clínico de 28 dias após internação. Foram coletadas e pontuadas as variáveis PELOD-2 no dia 1, qPELOD-2 no dia 1, pediatric Sequential Organ Failure Assessment (pSOFA) e Pediatric Multiple Organ Dysfunction Score (P-MODS). A curva da característica de operação do receptor (ROC) foi plotada e a eficiência preditiva do PELOD-2 no dia 1, o escore qPELOD-2 no dia 1, pSOFA, P-MODS com relação a óbito foram avaliados pela área abaixo da curva (AUC) da curva ROC. Resultados: O escore PELOD-2 no dia 1, escore qPELOD-2 no dia 1, pSOFA e P-MODS no grupo não sobrevida foram significativamente maiores do que os no grupo sobrevida. A análise preditiva da curva ROC mostrou que as AUCs do escore PELOD-2 no dia 1, escore qPELOD-2 no dia 1, pSOFA e P-MODS com relação ao prognóstico de crianças com sepse na UTIP foi 0,916, 0,802, 0,937 e 0,761, respectivamente (todas p < 0,05). Conclusões: Tanto o escore PELOD-2 no dia 1 e o escore qPELOD-2 no dia 1 foram válidos e conseguiram avaliar o prognóstico de crianças com sepse em uma UTIP de um país em desenvolvimento. Além disso, o escore PELOD-2 no dia 1 foi superior ao escore qPELOD-2 no dia 1. São necessários estudos adicionais para verificar a utilidade do escore qPELOD-2 no dia 1, principalmente fora da UTIP.

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          Most cited references30

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          The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

          Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.
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            Comparing the Areas under Two or More Correlated Receiver Operating Characteristic Curves: A Nonparametric Approach

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              Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

              The Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to infection." The performance of clinical criteria for this sepsis definition is unknown.
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                Author and article information

                Journal
                jped
                Jornal de Pediatria
                J. Pediatr. (Rio J.)
                Sociedade Brasileira de Pediatria (Porto Alegre, RS, Brazil )
                0021-7557
                1678-4782
                December 2020
                : 96
                : 5
                : 660-665
                Affiliations
                [1] Zhanjiang orgnameHospital of Guangdong Medical University orgdiv1Children's Medical Center of the Affiliated China
                Article
                S0021-75572020000500660 S0021-7557(20)09600500660
                10.1016/j.jped.2019.07.007
                9ad82d47-8b2b-4983-aae7-47c5add41246

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 18 July 2019
                : 13 January 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 6
                Product

                SciELO Brazil

                Categories
                Original Articles

                Sepsis,Prognóstico,Prognosis,"Quick" PELOD-2 score,Crianças,PELOD-2 score,Sepse,Escore PELOD-2,Children,Escore "quick"PELOD-2

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