Comparative assessment of the prognostic ability of paediatric Sequential Organ Failure Assessment (pSOFA), paediatric logistic organ dysfunction 2 (PELOD 2) and Vasoactive-Inotropic Score (VIS) in children with septic shock: a retrospective observational study

Abstract

INTRODUCTION: Septic shock is the most severe stage of sepsis in children accompanied by a highest mortality. OBJECTIVE: The aim of the work is to compare an informative significance of pSOFA, PELOD 2 scales and VIS as predictors of mortality in children with septic shock. MATERIALS AND METHODS: The design of the study is retrospective, observational, single-center trial. The study was performed in the Children's Regional Clinical Hospital of Krasnodar. The inclusion criteria were children with septic shock from 9 months to 17 years old. The endpoint of trial was 28-day mortality. Demographic and clinical characteristic were presented with median and average values, also interquartile intervals were counted. Mann-Whitney U-test was used for comparison data received. The discriminatory power, sensitivity and specificity were defined with receiver operating characteristic (ROC) analysis and determination of area under ROC curve (AUC). RESULTS: No one of this trial’s score provides a prediction of children’s survival with sepsis and shock during first 24 hour PICU stay. PELOD 2 and pSOFA scores allow to estimate a prediction from day 3 from PICU stay. Furthermore PELOD 2 score shows a higher informative significance. The VIS has an ability to predict survival on day 5 from admission. CONCLUSIONS: Only the PELOD 2 score has a good discriminatory power regarding the prognosis of survival in children with septic shock after 48 hours of intensive care. The VIS scale allow to assess a severity of cardiovascular dysfunction in children with refractory septic shock with threshold critical value more than 21 points.