PDF(Pubmed)
Abstract：
OBJECTIVE: We aimed to validate the performance of six available scoring models for predicting hospital mortality in children with suspected or confirmed infections.
METHODS: This single-center retrospective cohort study included pediatric patients admitted to the PICU for infection. The primary outcome was hospital mortality. The six scores included the age-adapted pSOFA score, SIRS score, PELOD2 score, Sepsis-2 score, qSOFA score, and PMODS.
RESULTS: Of the 5,356 children admitted to the PICU, 9.1% (488) died, and 25.1% (1,342) had basic disease with a mortality rate of 12.7% (171); 65.3% (3,499) of the patients were younger than 2 years, and 59.4% (3,183) were male. The discrimination abilities of the pSOFA and PELOD2 scores were superior to those of the other models. The calibration curves of the pSOFA and PELOD2 scores were consistent between the predictions and observations. Elevated lactate levels were a risk factor for mortality.
CONCLUSIONS: The pSOFA and PELOD2 scores had superior predictive performance for mortality. Given the relative unavailability of items and clinical operability, the pSOFA score should be recommended as an optimal tool for acute organ dysfunction in pediatric sepsis patients. Elevated lactate levels are related to a greater risk of death from infection in children in the PICU.
METHODS: This single-center retrospective cohort study included pediatric patients admitted to the PICU for infection. The primary outcome was hospital mortality. The six scores included the age-adapted pSOFA score, SIRS score, PELOD2 score, Sepsis-2 score, qSOFA score, and PMODS.
RESULTS: Of the 5,356 children admitted to the PICU, 9.1% (488) died, and 25.1% (1,342) had basic disease with a mortality rate of 12.7% (171); 65.3% (3,499) of the patients were younger than 2 years, and 59.4% (3,183) were male. The discrimination abilities of the pSOFA and PELOD2 scores were superior to those of the other models. The calibration curves of the pSOFA and PELOD2 scores were consistent between the predictions and observations. Elevated lactate levels were a risk factor for mortality.
CONCLUSIONS: The pSOFA and PELOD2 scores had superior predictive performance for mortality. Given the relative unavailability of items and clinical operability, the pSOFA score should be recommended as an optimal tool for acute organ dysfunction in pediatric sepsis patients. Elevated lactate levels are related to a greater risk of death from infection in children in the PICU.
摘要：
目的：我们旨在验证六个可用的评分模型在预测疑似或确诊感染儿童住院死亡率方面的性能。
方法：这项单中心回顾性队列研究包括因感染而进入PICU的儿科患者。主要结果是医院死亡率。六个分数包括适应年龄的pSOFA分数，SIRS评分,PELOD2评分，脓毒症-2评分,qSOFA分数,和PMODS。
结果：在入住PICU的5,356名儿童中，9.1%(488人)死亡，基础疾病占25.1％（1,342），死亡率为12.7％（171）；65.3％（3,499）的患者年龄小于2岁，男性占59.4%(3,183)。pSOFA和PELOD2得分的辨别能力优于其他模型。pSOFA和PEL0D2评分的校准曲线在预测和观察之间是一致的。乳酸水平升高是死亡的危险因素。
结论：pSOFA和PEL0D2评分对死亡率具有更好的预测性能。鉴于项目的相对可用性和临床可操作性，应推荐将pSOFA评分作为小儿脓毒症患者急性器官功能障碍的最佳工具.乳酸水平升高与PICU儿童感染死亡的风险更大有关。
方法：这项单中心回顾性队列研究包括因感染而进入PICU的儿科患者。主要结果是医院死亡率。六个分数包括适应年龄的pSOFA分数，SIRS评分,PELOD2评分，脓毒症-2评分,qSOFA分数,和PMODS。
结果：在入住PICU的5,356名儿童中，9.1%(488人)死亡，基础疾病占25.1％（1,342），死亡率为12.7％（171）；65.3％（3,499）的患者年龄小于2岁，男性占59.4%(3,183)。pSOFA和PELOD2得分的辨别能力优于其他模型。pSOFA和PEL0D2评分的校准曲线在预测和观察之间是一致的。乳酸水平升高是死亡的危险因素。
结论：pSOFA和PEL0D2评分对死亡率具有更好的预测性能。鉴于项目的相对可用性和临床可操作性，应推荐将pSOFA评分作为小儿脓毒症患者急性器官功能障碍的最佳工具.乳酸水平升高与PICU儿童感染死亡的风险更大有关。
