L Nelson Sanchez-Pinto1, Melania M Bembea2, Reid Wd Farris3, Mary E Hartman4, Folafoluwa O Odetola5, Michael C Spaeder6, R Scott Watson3, Jerry J Zimmerman3, Tellen D Bennett7. 1. Departments of Pediatrics (Critical Care) and Preventive Medicine (Health & Biomedical Informatics), Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. 2. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland. 3. Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington. 4. Department of Pediatrics, Washington University, St. Louis, Missouri. 5. Department of Pediatrics, University of Michigan, Ann Arbor, Michigan. 6. Department of Pediatrics, University of Virginia, Charlottesville, Virginia. 7. Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.
Abstract
OBJECTIVES: The goal of this study was to determine the incidence, prognostic performance, and generalizability of the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) organ dysfunction criteria using electronic health record (EHR) data. Additionally, we sought to compare the performance of the PODIUM criteria with the organ dysfunction criteria proposed by the 2005 International Pediatric Sepsis Consensus Conference (IPSCC). METHODS: Retrospective observational cohort study of critically ill children at 2 medical centers in the United States between 2010 and 2018. We assessed prevalence of organ dysfunction based on the PODIUM and IPSCC criteria for each 24-hour period from admission to 28 days. We studied the prognostic performance of the criteria to discriminate in-hospital mortality. RESULTS: Overall, 22 427 PICU admissions met inclusion criteria, and in-hospital mortality was 2.3%. The cumulative incidence of each PODIUM organ dysfunction ranged from 15% to 30%, with an in-hospital mortality of 6% to 10% for most organ systems. The number of concurrent PODIUM organ dysfunctions demonstrated good-to-excellent discrimination for in-hospital mortality (area under the curve 0.87-0.93 for day 1 through 28) and compared favorably to the IPSCC criteria (area under the curve 0.84-0.92, P < .001 to P = .06). CONCLUSIONS: We present the first evaluation of the PODIUM organ dysfunction criteria in 2 EHR databases. The use of the PODIUM organ dysfunction criteria appears promising for epidemiologic and clinical research studies using EHR data. More studies are needed to evaluate the PODIUM criteria that are not routinely collected in structured format in EHR databases.
OBJECTIVES: The goal of this study was to determine the incidence, prognostic performance, and generalizability of the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) organ dysfunction criteria using electronic health record (EHR) data. Additionally, we sought to compare the performance of the PODIUM criteria with the organ dysfunction criteria proposed by the 2005 International Pediatric Sepsis Consensus Conference (IPSCC). METHODS: Retrospective observational cohort study of critically ill children at 2 medical centers in the United States between 2010 and 2018. We assessed prevalence of organ dysfunction based on the PODIUM and IPSCC criteria for each 24-hour period from admission to 28 days. We studied the prognostic performance of the criteria to discriminate in-hospital mortality. RESULTS: Overall, 22 427 PICU admissions met inclusion criteria, and in-hospital mortality was 2.3%. The cumulative incidence of each PODIUM organ dysfunction ranged from 15% to 30%, with an in-hospital mortality of 6% to 10% for most organ systems. The number of concurrent PODIUM organ dysfunctions demonstrated good-to-excellent discrimination for in-hospital mortality (area under the curve 0.87-0.93 for day 1 through 28) and compared favorably to the IPSCC criteria (area under the curve 0.84-0.92, P < .001 to P = .06). CONCLUSIONS: We present the first evaluation of the PODIUM organ dysfunction criteria in 2 EHR databases. The use of the PODIUM organ dysfunction criteria appears promising for epidemiologic and clinical research studies using EHR data. More studies are needed to evaluate the PODIUM criteria that are not routinely collected in structured format in EHR databases.
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Ann Intern Med Date: 2007-10-16 Impact factor: 25.391
Authors: Scott L Weiss; Fran Balamuth; Marianne Chilutti; Mark Jason Ramos; Peter McBride; Nancy-Ann Kelly; K Joy Payton; Julie C Fitzgerald; Jeffrey W Pennington Journal: Pediatr Crit Care Med Date: 2020-02 Impact factor: 3.624
Authors: Scott L Weiss; Julie C Fitzgerald; John Pappachan; Derek Wheeler; Juan C Jaramillo-Bustamante; Asma Salloo; Sunit C Singhi; Simon Erickson; Jason A Roy; Jenny L Bush; Vinay M Nadkarni; Neal J Thomas Journal: Am J Respir Crit Care Med Date: 2015-05-15 Impact factor: 21.405
Authors: Bita Shakoory; Joseph A Carcillo; W Winn Chatham; Richard L Amdur; Huaqing Zhao; Charles A Dinarello; Randall Q Cron; Steven M Opal Journal: Crit Care Med Date: 2016-02 Impact factor: 7.598