Luregn J Schlapbach1,2,3, Scott L Weiss4,3, Melania M Bembea5, Joseph A Carcillo6, Francis Leclerc7,8, Stephane Leteurtre7,8, Pierre Tissieres9, James L Wynn10, Jerry Zimmerman11, Jacques Lacroix12. 1. Children's Research Center and Department of Intensive Care and Neonatology, University Children's Hospital Zurich, Zurich, Switzerland. 2. Child Health Research Centre, The University of Queensland, and Queensland Children's Hospital, Brisbane, Australia. 3. Contributed equally as co-first authors. 4. Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. 5. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. 6. Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 7. ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Université de Lille, CHU Lille, Lille, France. 8. EA 2694 Santé publique, épidémiologie et qualité des soins, Université de Lille, Lille, France. 9. Pediatric Intensive Care, Université Paris-Saclay, Le Kremlin-Bicêtre, France. 10. Department of Pediatrics and Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, Florida. 11. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, Washington. 12. Division of Pediatric Critical Care Medicine, Centre Hospitalier Universitaire de Sainte-Justine, Université de Montreal, QC, Canada.
Abstract
CONTEXT: Multiple scores exist to characterize organ dysfunction in children. OBJECTIVE: To review the literature on multiple organ dysfunction (MOD) scoring systems to estimate severity of illness and to characterize the performance characteristics of currently used scoring tools and clinical assessments for organ dysfunction in critically ill children. DATA SOURCES: Electronic searches of PubMed and Embase were conducted from January 1992 to January 2020. STUDY SELECTION: Studies were included if they evaluated critically ill children with MOD, evaluated the performance characteristics of scoring tools for MOD, and assessed outcomes related to mortality, functional status, organ-specific outcomes, or other patient-centered outcomes. DATA EXTRACTION: Data were abstracted into a standard data extraction form by a task force member. RESULTS: Of 1152 unique abstracts screened, 156 full text studies were assessed including a total of 54 eligible studies. The most commonly reported scores were the Pediatric Logistic Organ Dysfunction Score (PELOD), pediatric Sequential Organ Failure Assessment score (pSOFA), Pediatric Index of Mortality (PIM), PRISM, and counts of organ dysfunction using the International Pediatric Sepsis Definition Consensus Conference. Cut-offs for specific organ dysfunction criteria, diagnostic elements included, and use of counts versus weighting varied substantially. LIMITATIONS: While scores demonstrated an increase in mortality associated with the severity and number of organ dysfunctions, the performance ranged widely. CONCLUSIONS: The multitude of scores on organ dysfunction to assess severity of illness indicates a need for unified and data-driven organ dysfunction criteria, derived and validated in large, heterogenous international databases of critically ill children.
CONTEXT: Multiple scores exist to characterize organ dysfunction in children. OBJECTIVE: To review the literature on multiple organ dysfunction (MOD) scoring systems to estimate severity of illness and to characterize the performance characteristics of currently used scoring tools and clinical assessments for organ dysfunction in critically ill children. DATA SOURCES: Electronic searches of PubMed and Embase were conducted from January 1992 to January 2020. STUDY SELECTION: Studies were included if they evaluated critically ill children with MOD, evaluated the performance characteristics of scoring tools for MOD, and assessed outcomes related to mortality, functional status, organ-specific outcomes, or other patient-centered outcomes. DATA EXTRACTION: Data were abstracted into a standard data extraction form by a task force member. RESULTS: Of 1152 unique abstracts screened, 156 full text studies were assessed including a total of 54 eligible studies. The most commonly reported scores were the Pediatric Logistic Organ Dysfunction Score (PELOD), pediatric Sequential Organ Failure Assessment score (pSOFA), Pediatric Index of Mortality (PIM), PRISM, and counts of organ dysfunction using the International Pediatric Sepsis Definition Consensus Conference. Cut-offs for specific organ dysfunction criteria, diagnostic elements included, and use of counts versus weighting varied substantially. LIMITATIONS: While scores demonstrated an increase in mortality associated with the severity and number of organ dysfunctions, the performance ranged widely. CONCLUSIONS: The multitude of scores on organ dysfunction to assess severity of illness indicates a need for unified and data-driven organ dysfunction criteria, derived and validated in large, heterogenous international databases of critically ill children.
Authors: Mihir R Atreya; Natalie Z Cvijanovich; Julie C Fitzgerald; Scott L Weiss; Michael T Bigham; Parag N Jain; Adam J Schwarz; Riad Lutfi; Jeffrey Nowak; Geoffrey L Allen; Neal J Thomas; Jocelyn R Grunwell; Torrey Baines; Michael Quasney; Bereketeab Haileselassie; Christopher J Lindsell; Matthew N Alder; Hector R Wong Journal: Crit Care Date: 2022-07-11 Impact factor: 19.334
Authors: Bowen Fan; Juliane Klatt; Michael M Moor; Latasha A Daniels; Lazaro N Sanchez-Pinto; Philipp K A Agyeman; Luregn J Schlapbach; Karsten M Borgwardt Journal: Bioinformatics Date: 2022-06-24 Impact factor: 6.931