Performance of the PEdiatric Logistic Organ Dysfunction-2 score in critically ill children requiring plasma transfusions

Oliver Karam, Pierre Demaret, Alain Duhamel, Alison Shefler, Philip C. Spinella, Simon J. Stanworth, Marisa Tucci, Stéphane Leteurtre, the PlasmaTV investigators for the PlasmaTV investigators, Warwick Butt, Carmel Delzoppo, Kym Bain, Simon Erickson, Nathan Smalley, Tavey Dorofaeff, Debbie Long, Greg Wiseman, Stéphan Clénent de Cléty, Caroline Berghe, Annick de JaegerPierre Demaret, Marc Trippaerts, Ariane Willems, Shancy Rooze, Jozef De Dooy, Elaine Gilfoyle, Lynette Wohlgemuth, Marisa Tucci, Mariana Dumitrascu, Davinia Withington, Julia Hickey, Karen Choong, Lois Sanders, Gavin Morrison, Janice Tijssen, David Wensley, Gordon Krahn, Marc Andre Dugas, Louise Gosselin, Miriam Santschi, Bettina Von Dessauer, Nadia Ordenes, Arash Afshari, Lasse Hoegh Andersen, Jens Christian Nilsson, Mathias Johansen, Anne Mette Baek Jensen, Santiago Campos Mino, Michelle Grunauer, Nicolas Joram, Nicolas Roullet-Renoleau, Etienne Javouhey, Fleur Cour-Andlauer, Aurélie Portefaix, Olivier Brissaud, Julie Guichoux, Valérie Payen, Pierre Louis Léger, Mickael Afanetti, Guillaume Mortamet, Matthieu Maria, Audrey Breining, Pierre Tissieres, Aimée Dorkenoo, Anna Deho, Harry Steinherr, Filippia Nikolaou, Anna Camporesi, Federica Mario, Tatsuya Kawasaki, Shinya Miura, John Beca, Miriam Rea, Claire Sherring, Tracey Bushell, Gunnar Bentsen, Alexandra Dinis, Gabriela Pereira, Marisa Vieira, Marta Moniz, Saleh Alshehri, Manal Alasnag, Maria Pisarcikova, Iolanda Jordan, Joan Balcells, Antonio Perez-Ferrer, Jesús de Vicente Sánchez, Marta Vazquez Moyano, Antonio Morales Martinez, Jesus Lopez-Herce, Maria Jose Solana, Jose Carlos Flores González, Maria Teresa Alonso, Manuel Nieto Faza, Marie Hélène Perez, Vivianne Amiet, Carsten Doell, Alice Bordessoule, Suzan Cochius-den Otter, Berber Kapitein, Martin Kneyber, Joe Brierley, Vanessa Rea, Stephen McKeever, Andrea Kelleher, Barney Scholefield, Anke Top, Nicola Kelly, Satnam Virdee, Peter Davis, Susan George, Kay C. Hawkins, Katie McCall, Victoria Brown, Kim Sykes, Richard Levin, Isobel MacLeod, Marie Horan, Petr Jirasek, David Inwald, Amina Abdulla, Sophie Raghunanan, Bob Taylor, Alison Shefler, Hannah Sparkes, Sheila Hanson, Katherine Woods, David Triscari, Kathy Murkowski, Caroline Ozment, Marie Steiner, Dan Nerheim, Amanda Galster, Renee Higgerson, Lee Ann Christie, Philip C. Spinella, Daniel Martin, Liz Rourke, Jennifer Muszynski, Lisa Steele, Samuel Ajizian, Michael C. McCrory, Kevin O’Brien, Christopher Babbitt, Erin Felkel, Glenn Levine, Edward J. Truemper, Machelle Zink, Marianne Nellis, Neal J. Thomas, Debbie Spear, Barry Markovitz, Jeff Terry, Rica Morzov, Vicki Montgomery, Andrew Michael, Melissa Thomas, Marcy Singleton, Dean Jarvis, Sholeen Nett, Douglas Willson, Michelle Hoot, Melania Bembea, Alvin Yiu, David McKinley, Elizabeth Scarlett, Jennifer Sankey, Minal Parikh, E. Vincent, S. Faustino, Kelly Michelson, Jay Rilinger, Laura Campbell, Shira Gertz, Jill M. Cholette, Asumthia Jeyapalan, Margaret Parker, Scot Bateman, Amanda Johnson

Research output: Contribution to journalArticle

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Abstract

Background: Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions. Methods: This was an ancillary study of a prospective observational study on plasma transfusions over a 6-week period, in 101 PICUs in 21 countries. All critically ill children who received at least one plasma transfusion during the observation period were included. PELOD-2 scores were measured on days 1, 2, 5, 8, and 12 after plasma transfusion. Performance of the score was assessed by the determination of the discrimination (area under the ROC curve: AUC) and the calibration (Hosmer–Lemeshow test). Results: Four hundred and forty-three patients were enrolled in the study (median age and weight: 1 year and 9.1 kg, respectively). Observed mortality rate was 26.9 % (119/443). For PELOD-2 on day 1, the AUC was 0.76 (95 % CI 0.71–0.81) and the Hosmer–Lemeshow test was p = 0.76. The serial evaluation of the changes in the daily PELOD-2 scores from day 1 demonstrated a significant association with death, adjusted for the PELOD-2 score on day 1. Conclusions: In a subpopulation of critically ill children requiring plasma transfusion, the PELOD-2 score has a lower but acceptable discrimination than in an entire population. This score should therefore be used cautiously in this specific subpopulation.

Original languageEnglish (US)
Article number98
JournalAnnals of Intensive Care
Volume6
Issue number1
DOIs
StatePublished - Dec 1 2016

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All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Karam, O., Demaret, P., Duhamel, A., Shefler, A., Spinella, P. C., Stanworth, S. J., Tucci, M., Leteurtre, S., for the PlasmaTV investigators, T. PV. I., Butt, W., Delzoppo, C., Bain, K., Erickson, S., Smalley, N., Dorofaeff, T., Long, D., Wiseman, G., Clénent de Cléty, S., Berghe, C., ... Johnson, A. (2016). Performance of the PEdiatric Logistic Organ Dysfunction-2 score in critically ill children requiring plasma transfusions. Annals of Intensive Care, 6(1), [98]. https://doi.org/10.1186/s13613-016-0197-6