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      Day-1 PELOD-2 and day-1 “quick” PELOD-2 scores in children with sepsis in the PICU

      , , , , , ,
      Jornal de Pediatria
      Elsevier BV

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          Abstract

          <div class="section"> <a class="named-anchor" id="d6759055e157"> <!-- named anchor --> </a> <h5 class="section-title" id="d6759055e158">Objectives</h5> <p id="d6759055e160">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. </p> </div><div class="section"> <a class="named-anchor" id="d6759055e162"> <!-- named anchor --> </a> <h5 class="section-title" id="d6759055e163">Methods</h5> <p id="d6759055e165">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). </p> </div><div class="section"> <a class="named-anchor" id="d6759055e167"> <!-- named anchor --> </a> <h5 class="section-title" id="d6759055e168">Results</h5> <p id="d6759055e170">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 &lt; 0.05). </p> </div><div class="section"> <a class="named-anchor" id="d6759055e172"> <!-- named anchor --> </a> <h5 class="section-title" id="d6759055e173">Conclusions</h5> <p id="d6759055e175">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. </p> </div><div class="section"> <a class="named-anchor" id="d6759055e180"> <!-- named anchor --> </a>0bjetivos <p id="d6759055e183">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. </p> </div><div class="section"> <a class="named-anchor" id="d6759055e185"> <!-- named anchor --> </a>Métodos <p id="d6759055e188">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, <i>pediatric Sequential Organ Failure Assessment</i> (pSOFA) e <i>Pediatric Multiple Organ Dysfunction Score</i> (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. </p> </div><div class="section"> <a class="named-anchor" id="d6759055e196"> <!-- named anchor --> </a>Resultados <p id="d6759055e199">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 &lt; 0,05). </p> </div><div class="section"> <a class="named-anchor" id="d6759055e201"> <!-- named anchor --> </a>Conclusões <p id="d6759055e204">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. </p> </div>

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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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              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
                Jornal de Pediatria
                Jornal de Pediatria
                Elsevier BV
                00217557
                September 2019
                September 2019
                Article
                10.1016/j.jped.2019.07.007
                9ad82d47-8b2b-4983-aae7-47c5add41246
                © 2019

                https://www.elsevier.com/tdm/userlicense/1.0/

                http://creativecommons.org/licenses/by-nc-nd/4.0/

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