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Abstract PD-013: EXTERNAL VALIDATION OF THE “QUICK” PEDIATRIC LOGISTIC ORGAN DYSFUNCTION-2 SCORE USING A LARGE NORTH AMERICAN COHORT OF CRITICALLY ILL CHILDREN

Peters, C.1; Gorges, M.2; Murthy, S.1; Pi, S.3; Kisson, N.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 32–33
doi: 10.1097/01.pcc.0000537415.31344.85
Poster Discussion Abstracts
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1BC Children’s Hospital, Critical Care Pediatrics, Vancouver, Canada

2BC Children’s Hospital, Department of Anesthesiology- Pharmacology & Therapeutics, Vancouver, Canada

3BC Children’s Hospital, Pediatrics, Vancouver, Canada

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Aims & Objectives:

Early detection of sepsis is important to decrease its substantial mortality [PMID: 25734408]. A quick Pediatric Logistic Organ Dysfunction-2 score on day 1 (qPELOD2) [28492402] was useful in predicting mortality with an area under receiver operating characteristic curve (AUC) of 0.91 (95%CI 0.86–0.96) in children admitted to a PICU with suspected infection [28492402]. We performed an external validation of the qPELOD2 score.

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Methods

A secondary analysis was performed using data from the Virtual Pediatric Systems registry of records from 130 PICUs in North America. Children with an infectious diagnosis code admitted between January 2009 and December 2014 were included. Systolic blood pressures, heart rates, and Glasgow coma scores were used to evaluate the qPELOD2 score [28492402]. Performance was compared with pediatric risk of mortality III (PRISM3) [8706448] and pediatric index of mortality 2 (PIM2) risk scores [12541154].

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Results

Data from 42,196 children, of median age 2.7 (IQR 0.7–8.8, range 0–18) years and with a 4.27% mortality rate, were analyzed. Mortality was 13.4% with a qPELOD2 ≥2, and 2.5% for qPELOD2 <2. The AUC of qPELOD2 was 72.6 (95%CI 71.4−73.8) (Figure 1). Performance of the qPELOD2 was worst in the >12 years age group: AUC 67.8 (95% CI 65−70.5), and best in the <1 month age group: AUC 78.9 (95%CI 75.3−82.4) (Figure 2).

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Conclusions

qPELOD2 performed significantly poorer in our cohort, compared to the original study. Further work is needed to needed to discern the reason and to develop a robust quick pediatric sepsis diagnostic tool for both research and clinical care.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies