Abstract Ref Number = APCP1188
SERIAL ESTIMATIONOF THE SEVERITY OF MULTIPLE ORGAN DYSFUNCTION SYNDROME IN CRITICALLY ILL CHILDREN BY USING PELOD – 2 SCORE
SANTOSH T SOANS, PHANI KRISHNA, ASHWIJ SHRIYAN
Junior resident, AJ Institute of Medical Sciences, Mangalore, India
Head of Department of Paediatrics Professor, AJ Institute of Medical Sciences, Mangalore
Assistant Professor, AJ Institute of Medical Sciences, Mangalore, India
Background: PELOD-2 is frequently used for mortality prediction in the paediatric population. It allows assessment of the severity of cases of multiple organ dysfunction syndrome in the PICU with a continuous scale. The primary aim of the study was to validate the daily PELOD-2 score using the set of seven days as predictors of PICU death.
Methodology: It was a Prospective, Cross sectional Study involving 106 patients admitted to the PICU of AJIMS, Mangalore between November 2015 - November 2017.Patients baseline characteristics were obtained. PELOD-2 scores were noted 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.
Result: A total of 106 children were analysed. 52.8% patients survived and 47.2% expired. 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%).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. The correlation between high PELOD scores on admission and also high mortality was obtained and it was statistically significant. (p=0.001).
Conclusion : High PELOD 2 Scores on Admission are associated with High Mortality rates. PELOD 2 score increases significantly with increase in organ involvement.