PURPOSE: To evaluate whether changes in outcome prediction scores during the first 72 hours after admission to a pediatric intensive care unit (PICU) are more predictive of outcome than single assessments at admission in pediatric oncology patients requiring mechanical ventilatory support for more than 3 days. PATIENTS AND METHODS: The medical records of 54 consecutive pediatric oncology patients requiring mechanical ventilation over 72 hours in the PICU of the Asan Medical Center, Seoul, Korea, between January 2006 and December 2008, were retrospectively reviewed. RESULTS: Although both initial Sequential Organ Failure Assessment (SOFA) score and change in SOFA score (Δ-SOFA) correlated well with mortality, Δ-SOFA score showed a significantly stronger correlation (P<0.001) and a larger area under the receiver operating characteristic curve than did initial SOFA score. Patients with positive and negative Δ-SOFA scores showed statistically significant differences in mortality (18.5% vs. 88.2%, P<0.001). In addition, early changes in respiratory parameters, such as PaO₂/FiO₂ (P/F) ratio, oxygenation index (OI), and ventilation index (VI), evaluated serially during the first 3 days, also correlated with mortality. Patients showing improvement in these respiratory parameters displayed significantly lower mortality than did patients with worsening of these parameters (P<0.01). CONCLUSIONS: Serial evaluation of SOFA score during the first few days after PICU admission was a good predictor of prognosis in pediatric oncology patients mechanically ventilated over 3 days. Independent of initial SOFA score, Δ-SOFA score during the first 72 hours closely correlated with outcome. Early changes in respiratory parameters, such as P/F ratio, OI, and VI, may also provide valuable prognostic information in such patients.
PURPOSE: To evaluate whether changes in outcome prediction scores during the first 72 hours after admission to a pediatric intensive care unit (PICU) are more predictive of outcome than single assessments at admission in pediatric oncology patients requiring mechanical ventilatory support for more than 3 days. PATIENTS AND METHODS: The medical records of 54 consecutive pediatric oncology patients requiring mechanical ventilation over 72 hours in the PICU of the Asan Medical Center, Seoul, Korea, between January 2006 and December 2008, were retrospectively reviewed. RESULTS: Although both initial Sequential Organ Failure Assessment (SOFA) score and change in SOFA score (Δ-SOFA) correlated well with mortality, Δ-SOFA score showed a significantly stronger correlation (P<0.001) and a larger area under the receiver operating characteristic curve than did initial SOFA score. Patients with positive and negative Δ-SOFA scores showed statistically significant differences in mortality (18.5% vs. 88.2%, P<0.001). In addition, early changes in respiratory parameters, such as PaO₂/FiO₂ (P/F) ratio, oxygenation index (OI), and ventilation index (VI), evaluated serially during the first 3 days, also correlated with mortality. Patients showing improvement in these respiratory parameters displayed significantly lower mortality than did patients with worsening of these parameters (P<0.01). CONCLUSIONS: Serial evaluation of SOFA score during the first few days after PICU admission was a good predictor of prognosis in pediatric oncology patients mechanically ventilated over 3 days. Independent of initial SOFA score, Δ-SOFA score during the first 72 hours closely correlated with outcome. Early changes in respiratory parameters, such as P/F ratio, OI, and VI, may also provide valuable prognostic information in such patients.
Authors: Matt S Zinter; Steven G DuBois; Aaron Spicer; Katherine Matthay; Anil Sapru Journal: Intensive Care Med Date: 2014-07-15 Impact factor: 17.440
Authors: Julie C Fitzgerald; Yimei Li; Brian T Fisher; Yuan-Shung Huang; Tamara P Miller; Rochelle Bagatell; Alix E Seif; Richard Aplenc; Neal J Thomas Journal: Pediatr Crit Care Med Date: 2018-06 Impact factor: 3.624
Authors: Matt S Zinter; Brent R Logan; Caitrin Fretham; Anil Sapru; Allistair Abraham; Mahmoud D Aljurf; Staci D Arnold; Andrew Artz; Jeffery J Auletta; Saurabh Chhabra; Edward Copelan; Christine Duncan; Robert P Gale; Eva Guinan; Peiman Hematti; Amy K Keating; David I Marks; Richard Olsson; Bipin N Savani; Celalettin Ustun; Kirsten M Williams; Marcelo C Pasquini; Christopher C Dvorak Journal: Biol Blood Marrow Transplant Date: 2019-09-26 Impact factor: 5.742
Authors: Shannon L Maude; Julie C Fitzgerald; Brian T Fisher; Yimei Li; Yuan-Shung Huang; Kari Torp; Alix E Seif; Marko Kavcic; Dana M Walker; Kateri H Leckerman; Todd J Kilbaugh; Susan R Rheingold; Lillian Sung; Theoklis E Zaoutis; Robert A Berg; Vinay M Nadkarni; Neal J Thomas; Richard Aplenc Journal: Pediatr Crit Care Med Date: 2014-02 Impact factor: 3.624