Scoring Systems for Organ Dysfunction and Multiple Organ Dysfunction: The PODIUM Consensus Conference.
Scoring Systems for Organ Dysfunction and Multiple Organ Dysfunction: The PODIUM Consensus Conference.
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DOI：
10.1542/peds.2021-052888d
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发表时间：
2022-01-01
期刊：
影响因子：
8
通讯作者：
Lacroix, Jacques
中科院分区：
文献类型：
--
作者：
Schlapbach, Luregn J.;Weiss, Scott L.;Bembea, Melania M.;Carcillo, Joseph A.;Leclerc, Francis;Leteurtre, Stephane;Tissieres, Pierre;Wynn, James L.;Zimmerman, Jerry;Lacroix, Jacques
Multiple scores exist to characterize organ dysfunction in children. 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. Electronic searches of PubMed and EMBASE were conducted from January 1992 to January 2020. 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 was abstracted into a standard data extraction form by a task force member. 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), Paediatric 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. While scores demonstrated an increase in mortality associated with the severity and number of organ dysfunctions, the performance ranged widely. 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. We reviewed the literature on organ dysfunction scoring systems characterizing the performance of currently used tools to assess organ dysfunction in critically ill children.
Multiple scores exist to characterize organ dysfunction in children. 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. Electronic searches of PubMed and EMBASE were conducted from January 1992 to January 2020. 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 was abstracted into a standard data extraction form by a task force member. 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), Paediatric 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. While scores demonstrated an increase in mortality associated with the severity and number of organ dysfunctions, the performance ranged widely. 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. We reviewed the literature on organ dysfunction scoring systems characterizing the performance of currently used tools to assess organ dysfunction in critically ill children.