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Ann Intensive Care. 2016 Dec;6(1):98. doi: 10.1186/s13613-016-0197-6. Epub 2016 Oct 6.

Performance of the PEdiatric Logistic Organ Dysfunction-2 score in critically ill children requiring plasma transfusions.

Collaborators (169)

Butt W, Delzoppo C, Bain K, Erickson S, Smalley N, Dorofaeff T, Long D, Wiseman G, Clénent de Cléty S, Berghe C, de Jaeger A, Demaret P, Trippaerts M, Willems A, Rooze S, De Dooy J, Gilfoyle E, Wohlgemuth L, Tucci M, Dumitrascu M, Withington D, Hickey J, Choong K, Sanders L, Morrison G, Tijssen J, Wensley D, Krahn G, Dugas MA, Gosselin L, Santschi M, Von Dessauer B, Ordenes N, Afshari A, Andersen LH, Nilsson JC, Johansen M, Baek Jensen AM, Campos Mino S, Grunauer M, Joram N, Roullet-Renoleau N, Javouhey E, Cour-Andlauer F, Portefaix A, Brissaud O, Guichoux J, Payen V, Léger PL, Afanetti M, Mortamet G, Maria M, Breining A, Tissieres P, Dorkenoo A, Deho A, Steinherr H, Nikolaou F, Camporesi A, Mario F, Kawasaki T, Miura S, Beca J, Rea M, Sherring C, Bushell T, Bentsen G, Dinis A, Pereira G, Vieira M, Moniz M, Alshehri S, Alasnag M, Pisarcikova M, Jordan I, Balcells J, Perez-Ferrer A, de Vicente Sánchez J, Vazquez Moyano M, Morales Martinez A, Lopez-Herce J, Solana MJ, Flores González JC, Alonso MT, Nieto Faza M, Perez MH, Amiet V, Doell C, Bordessoule A, Cochius-den Otter S, Kapitein B, Kneyber M, Brierley J, Rea V, McKeever S, Kelleher A, Scholefield B, Top A, Kelly N, Virdee S, Davis P, George S, Hawkins KC, McCall K, Brown V, Sykes K, Levin R, MacLeod I, Horan M, Jirasek P, Inwald D, Abdulla A, Raghunanan S, Taylor B, Shefler A, Sparkes H, Hanson S, Woods K, Triscari D, Murkowski K, Ozment C, Steiner M, Nerheim D, Galster A, Higgerson R, Christie L, Spinella PC, Martin D, Rourke L, Muszynski J, Steele L, Ajizian S, McCrory MC, O'Brien K, Babbitt C, Felkel E, Levine G, Truemper EJ, Zink M, Nellis M, Thomas NJ, Spear D, Markovitz B, Terry J, Morzov R, Montgomery V, Michael A, Thomas M, Singleton M, Jarvis D, Nett S, Willson D, Hoot M, Bembea M, Yiu A, McKinley D, Scarlett E, Sankey J, Parikh M, Faustino EVS, Michelson K, Rilinger J, Campbell L, Gertz S, Cholette JM, Jeyapalan A, Parker M, Bateman S, Johnson A.

Author information

1
Pediatric Intensive Care Unit, Geneva University Hospital, Geneva, Switzerland. oliver.karam@hcuge.ch.
2
Univ. Lille, EA 2694 - Santé Publique: épidémiologie et qualité des soins, 59000, Lille, France. oliver.karam@hcuge.ch.
3
Univ. Lille, EA 2694 - Santé Publique: épidémiologie et qualité des soins, 59000, Lille, France.
4
Pediatric Intensive Care Unit, CHC Liège, Liège, Belgium.
5
Department of Biostatistics, CHU Lille, 59000, Lille, France.
6
Pediatric Intensive Care Unit, Oxford University Hospitals, Oxford, UK.
7
Division of Critical Care, Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA.
8
NHS Blood and Transplant, John Radcliffe Hospital, Oxford, UK.
9
Pediatric Intensive Care Unit, CHU Sainte-Justine, Montreal, Canada.
10
Pediatric Intensive Care Unit, CHU Lille, 59000, Lille, France.

Abstract

BACKGROUND:

Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions.

METHODS:

This was an ancillary study of a prospective observational study on plasma transfusions over a 6-week period, in 101 PICUs in 21 countries. All critically ill children who received at least one plasma transfusion during the observation period were included. PELOD-2 scores were measured on days 1, 2, 5, 8, and 12 after plasma transfusion. Performance of the score was assessed by the determination of the discrimination (area under the ROC curve: AUC) and the calibration (Hosmer-Lemeshow test).

RESULTS:

Four hundred and forty-three patients were enrolled in the study (median age and weight: 1 year and 9.1 kg, respectively). Observed mortality rate was 26.9 % (119/443). For PELOD-2 on day 1, the AUC was 0.76 (95 % CI 0.71-0.81) and the Hosmer-Lemeshow test was p = 0.76. The serial evaluation of the changes in the daily PELOD-2 scores from day 1 demonstrated a significant association with death, adjusted for the PELOD-2 score on day 1.

CONCLUSIONS:

In a subpopulation of critically ill children requiring plasma transfusion, the PELOD-2 score has a lower but acceptable discrimination than in an entire population. This score should therefore be used cautiously in this specific subpopulation.

KEYWORDS:

Children; Critical care; Multiple organ failure; Outcome; Plasma transfusion; Score

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