Performance of the pediatric logistic organ dysfunction (PELOD) and (PELOD-2) scores in a pediatric intensive care unit of a developing country

Abstract

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 ² = 9.9, p = 0.27), while PELOD showed poor calibration (χ ² = 42, p = 0.000) in the same studied group.

Conclusion: 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.

Keywords: Calibration; Discrimination; Multiple organ dysfunction syndrome (MODS); Pediatric logistic organ dysfunction (PELOD, PELOD-2); Performance; Validation.