Phani krishna
AJ Institute of Medical Sciences, India
Title: Serial Estimation of the Severity of Multiple Organ Dysfunction Syndrome in Critically ill Children by Using Pelod – 2 Score
Biography
Biography: Phani krishna
Abstract
Aim and Objectives of the study:
To Validate the daily PELOD-2 score using the set of seven days as predictors of PICU death.
Material and methods:
Source of data : Prospective, Observational, Analytical, Cross sectional Design Patients admitted to the PICU of AJIMS, Mangalore from November 2015- November 2017 are considered.
All patients fulfilling the inclusion criteria will be included as study subjects after obtaining informed consent. PELOD-2 score will be used to predict the outcome of the patients.
This includes 11 variables as mentioned in below table. Patients baseline characteristics and calculated PELOD-2 score at days 1, 2, 5, 8, 12, 16 and 18 in PICU.
For each variable, the most abnormal value each day was used in calculating the PELOD-2 score.
Organ dysfunction was defined as a PELOD-2 score >0 for a given organ, and MODS as the simultaneous presence of two or more organ dysfunctions The PICU discharge status (death/survival) was used as the outcome dependent variable.
RESULTS :
A total of 106 children were analyzed. 52.8% patients survived and 47.2% expired. The overall mortality rate was 47.2 %. 66 were males, accounting for 62% and 40 were females, accounting for 38%. The male to female ratio was 1.6:1. Major cases had nervous system involvement., i.e.,43%, among which 48.8% expired and 51.2% survived. The next common system involvement was respiratory (31%) followed by cardiovascular (21%).71 patients had a score of >20 on day 1(i.e., day of admission),48 patients had a score of >20 on day 2, 26 patients on day 5, 15 patients on day 8 and 7 patients on day 12., and it correlated with the mortality (p <0.001). 90% cases where 4 organ systems were involved expired, as compared to only 4.8 % when it was single organ involvement.,confirming that mortality is directly proportional to the number of organ systems involved.
PELOD score of >20 was associated with higher mortality rate, being 60.6% (p=0.001).81.8% of the patients with a score of <10 survived in our study.
The correlation between high PELOD scores on admission and also high mortality was obtained and it was statistically significant . (p=0.001).
CONCLUSION:
The PELOD-2 scores increased significantly with increase in organ involvement.The best indicators of poor outcome in our study were number of organ dysfunction and PELOD-2 score.