Leteurtre et al updated the Pediatric Logistic Organ Dysfunction (PELOD) score for pediatric patients receiving intensive care. The authors are from multiple hospitals in France and Belgium and the Groupe Francophone de Reanimation et d'Urgences Pediatriques (GFRUP).
Patient selection: pediatric patient receiving intensive care
Parameters - using worst value within 24 hour period:
(1) Glasglow coma score (GCS) from 3 to 15
(2) pupillary reaction (nonreactive pupil must be > 3 mm. Do not assess after iatrogenic pupillary dilatation)
(3) lactatemia (mmol/L)
(4) mean arterial pressure (mm Hg) for age
(5) serum creatinine in µmol/L for age
(6) PaO2 to FIO2 ratio
(7) PaCO2 in mm Hg
(8) invasive ventilation
(9) WBC count in 10^9/L
(10) platelets in 10^9/L
If a variable is not measured then it is considered normal.
|
Parameter |
Finding |
Points |
|
Glasgow coma score |
11 to 15 |
0 |
|
|
5 to 10 |
1 |
|
|
3 or 4 |
4 |
|
pupillary reaction |
both fixed |
5 |
|
|
other |
0 |
|
lactatemia |
< 5.0 mmol/L |
0 |
|
|
5.0 to 10.9 mmol/L |
1 |
|
|
>= 11.0 |
4 |
|
mean arterial pressure |
>= 46 and < 1 month |
0 |
|
|
>= 55 and 1-11 months |
0 |
|
|
>= 60 and 12-23 months |
0 |
|
|
>= 62 and 24-59 months |
0 |
|
|
>= 65 and 60-143 months |
0 |
|
|
>= 67 and >= 144 months |
0 |
|
|
31-45 and < 1 month |
2 |
|
|
39-54 and 1-11 months |
2 |
|
|
44-59 and 12-23 months |
2 |
|
|
46-61 and 24-59 months |
2 |
|
|
49-64 and 60-143 months |
2 |
|
|
52-66 and >= 144 months |
2 |
|
|
17-30 and < 1 month |
3 |
|
|
25-38 and 1-11 months |
3 |
|
|
31-43 and 12-23 months |
3 |
|
|
32-44 and 24-59 months |
3 |
|
|
36-48 and 60-143 months |
3 |
|
|
38-51 and >= 144 months |
3 |
|
|
<= 16 and < 1 month |
6 |
|
|
<= 24 and 1-11 months |
6 |
|
|
<= 30 and 12-23 months |
6 |
|
|
<= 31 and 24-59 months |
6 |
|
|
<= 35 and 60-143 months |
6 |
|
|
<= 37 and >= 144 months |
6 |
|
creatinine |
<= 69 and < 1 month |
0 |
|
|
<= 22 and 1-11 months |
0 |
|
|
<= 34 and 12-23 months |
0 |
|
|
<= 50 and 24-59 months |
0 |
|
|
<= 58 and 60-143 months |
0 |
|
|
<= 92 and >= 144 months |
0 |
|
|
>= 70 and < 1 month |
2 |
|
|
>= 23 and 1-11 months |
2 |
|
|
>= 35 and 12-23 months |
2 |
|
|
>= 51 and 24-59 months |
2 |
|
|
>= 59 and 60-143 months |
2 |
|
|
>= 93 and >= 144 months |
2 |
|
PaO2 to FIO2 |
>= 61 |
0 |
|
|
<= 60 |
2 |
|
PaCO2 |
<= 58 mm Hg |
0 |
|
|
59 to 94 mm Hg |
1 |
|
|
>= 95 mm Hg |
3 |
|
invasive ventilation |
no |
0 |
|
|
yes |
3 |
|
WBC count |
> 2.0*10^9/L |
0 |
|
|
<= 2.0*10^9/L |
2 |
|
platelet count |
>= 142*10^9/L |
0 |
|
|
77-141 |
1 |
|
|
<=76*10^9/L |
2 |
total score =
= SUM(points for all 10 parameters)
subscore for neurologic dysfunction =
= (points for GCS) + (points for pupillary reaction)
subscore for respiratory dysfunction =
= (points for PaO2 to FIO2 ratio) + (points for PaCO2) + (points for invasive ventilation)
subscore for cardiovascular dysfunction =
= (points for MAP) + (points for lactatemia)
subscore for renal dysfunction =
= (points for serum creatinine)
subscore for hematologic dysfunction =
= (points for WBC) + (points for platelet count)
Interpretation:
• minimum score: 0
• maximum score: 33
• The higher the score the worse the mortality.
X =
= (0.47 * (total score)) - 6.61
probability of mortality =
= 1 / (1 + EXP((-1) *X))
Performance:
• The area under the ROC curve was 0.93.
Specialty: Critical Care, Emergency Medicine, Pedatrics
