Patterns of Organ Dysfunction in Critically Ill Children Based on PODIUM Criteria.
Patterns of Organ Dysfunction in Critically Ill Children Based on PODIUM Criteria.
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DOI：
10.1542/peds.2021-052888p
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发表时间：
2022-01-01
期刊：
影响因子：
8
通讯作者：
Bennett, Tellen D.
中科院分区：
文献类型：
--
作者：
Sanchez-Pinto, L. Nelson;Bembea, Melania M.;Farris, Reid Wd;Hartman, Mary E.;Odetola, Folafoluwa O.;Spaeder, Michael C.;Watson, R. Scott;Zimmerman, Jerry J.;Bennett, Tellen D.
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). Retrospective observational cohort study of critically ill children at two medical centers in the US between 2010–2018. 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 organ dysfunction criteria to discriminate in-hospital mortality. Overall, 22,427 PICU admissions (hospital A: 14,156, hospital B: 8,271) met inclusion criteria and in-hospital mortality was 2.3%. The cumulative incidence of each organ dysfunction based on the PODIUM criteria ranged from 15–30% with an associated in-hospital mortality of 6–10% for most organ systems. The number of concurrent PODIUM organ dysfunction criteria demonstrated good-to-excellent discrimination for in-hospital mortality (area under the curve [AUC] 0.87–0.93 for day 1 through 28) and compared favorably to the IPSCC criteria (AUC 0.84–0.92, p<0.001 to p=0.06). We present the first evaluation of the PODIUM organ dysfunction criteria in two EHR databases. The use of the PODIUM organ dysfunction criteria appears promising for epidemiologic and clinical research studies using EHR data. Further studies are needed to evaluate the PODIUM criteria that are not routinely collected in structured format or are infrequently recorded in EHR databases.
