El-Nawawy Ahmed, Mohsen Aly Abdel, Abdel-Malik Manal, Taman Sarah Omar
Department of Pediatrics, Alexandria University, Faculty of Medicine, El-Shatby Hospital Alexandria, Alexandria, Egypt.
Eur J Pediatr. 2017 Jul;176(7):849-855. doi: 10.1007/s00431-017-2916-x. Epub 2017 May 10.
The study aimed to compare two scores: the pediatric logistic organ dysfunction (PELOD) with its updated version (PELOD-2) in describing the severity of organ dysfunction in pediatric intensive care unit (PICU) and assess the performance of PELOD-2 in the Egyptian population. A prospective cohort study of 200 patients consecutively admitted to PICU between July 2015 and A 2016 was included. The median age was 6 months, and the male to female ratio was 1.04. The median length of PICU stay was 4 days. The overall predicted number of deaths using PELOD was 76 patients whereas, by PELOD-2, it was 50 patients. The observed mortality was 50 patients. The area under the receiving operating characteristic curve was excellent for both PELOD and PELOD-2 (0.93 and 0.91, respectively). The Hosmer and Lemeshow goodness-of-fit test showed good calibration of PELOD-2 (χ = 9.9, p = 0.27), while PELOD showed poor calibration (χ = 42, p = 0.000) in the same studied group.
Both scores had excellent discrimination. PELOD-2 is reproducible and easier to perform and had better calibration compared to PELOD score. What is Known: • Pediatric logistic organ dysfunction (PELOD) score was developed 1999 and validated in 2003 to describe the organ dysfunction severity in pediatric intensive care units. • A new and easier version of (PELOD-2) was developed 2013 in France and Belgium to replace the old score. It is important to assess the performance of the new score in other population else than the original. What is New: In an Egyptian pediatric intensive care, the performance of the score revealed: • PELOD-2 was an excellent discriminatory score comparable to the original score. • PELOD-2 calibrated well in the Egyptian population while the old score had poor calibration.
本研究旨在比较两个评分系统:小儿逻辑器官功能障碍评分(PELOD)及其更新版本(PELOD - 2)在描述儿科重症监护病房(PICU)中器官功能障碍的严重程度,并评估PELOD - 2在埃及人群中的表现。纳入了一项对2015年7月至2016年A期间连续入住PICU的200例患者的前瞻性队列研究。中位年龄为6个月,男女比例为1.04。PICU住院时间的中位数为4天。使用PELOD预测的死亡总数为76例患者,而使用PELOD - 2预测的为50例患者。观察到的死亡人数为50例患者。PELOD和PELOD - 2的受试者工作特征曲线下面积均极佳(分别为0.93和0.91)。在同一研究组中,Hosmer和Lemeshow拟合优度检验显示PELOD - 2校准良好(χ² = 9.9,p = 0.27),而PELOD校准不佳(χ² = 42,p = 0.000)。
两个评分系统均具有出色的辨别能力。PELOD - 2具有可重复性且更易于操作,与PELOD评分相比校准更好。已知信息:•小儿逻辑器官功能障碍(PELOD)评分于1999年制定,并于2003年验证,用于描述儿科重症监护病房中器官功能障碍的严重程度。•2013年在法国和比利时开发了一个更新且更简便的版本(PELOD - 2)以取代旧评分。评估新评分在原人群以外的其他人群中的表现很重要。新发现:在埃及儿科重症监护中,该评分的表现显示:•PELOD - 2是一个与原始评分相当的出色辨别性评分。•PELOD - 2在埃及人群中校准良好,而旧评分校准不佳。