COMPARISON OF PEDIATRIC LOGISTIC ORGAN DYSFUNCTION (PELOD) SCORE AND PEDIATRIC RISK OF MORTALITY (PRISM) III AS A MORTALITY PREDICTOR IN PATIENTS WITH DENGUE SHOCK SYNDROME
INTRODUCTION: The mortality rate for dengue shock syndrome (DSS) in the PICU at Children's and Maternity Harapan Kita Hospital is still high (13.2%).
OBJECTIVE: We evaluated performance of the Pediatric Logistic Organ Dysfunction (PELOD) score compared with the Pediatric Risk of Mortality III (PRISM III) for predicting mortality in our PICU.
METHODS: A total of 42 patients (48% boys, 52% girls) admitted to the PICU from January to December 2006 were enrolled onto the study. Diagnosis of DSS was made according to 1997 World Health Organization criteria and confirmed with serologic-positive dengue blot taken on the fifth day of fever (93% secondary infection and 7% primary infection). PELOD and PRISM scores were evaluated on the first day.
RESULTS: From 42 admissions, 1 was excluded for insufficient data. Median age of the children was 7 years. Death occurred in 11.9% of the patients with DSS. Analysis showed that the mean PELOD score was 7.2 (Mann-Whitney U test between survivors and nonsurvivors was significant at P = .001) compared with the PRISM III (mean score was significant also at P = .008). The receiver operating characteristic curves for the PELOD and PRISM III were 0.954 and 0.868, respectively.
CONCLUSIONS: PELOD and PRISM III scores showed a good discrimination for predicting mortality in patients with DSS in our PICU.
Submitted by Henny R. Iskandar
- Copyright © 2008 by the American Academy of Pediatrics