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Objective:To investigate the effect of 3 pediatric scores of critical illness including Pediatric Critical Illness Score (PCIS), Pediatric Logistic Organ Dysfunction Score 2 (PELOD-2), and Pediatric Multiple Organ Dysfunction Score (P-MODS) in estimating the prognosis of illness in children with sepsis in pediatric intensive care unit (PICU).Methods:The data of 516 pediatric patients diagnosed as sepsis in PICU of Affiliated Hospital of Guangdong Medical University from June 2016 to June 2018 were retrospectively analyzed, and they were divided into survival group and death group according to the clinical outcome on the 28 th day after admission.Then, the receiver operating characteristic (ROC) curve was plotted, and the efficiency of PCIS, PELOD-2 and P-MODS for predicting death was evaluated by the area under ROC curve (AUC). Results:There were 488 pediatric patients survived, while 28 cases died during hospitalization.Compared with the survival group, the death group had a significantly lower PCIS score [86(82, 88) scores vs.89(84, 92)scores], and significantly higher PELOD-2 and P-MODS scores[PELOD-2: 6.5(4.0, 8.0) scores vs.0 (0, 2.0) scores, P-MODS: 3(2, 6) scores vs.1(1, 2) scores], and the differences were significant( Z=3 259.500, 14.228, 4.688, all P<0.05). ROC curve analysis showed that the AUCs of PCIS, PELOD-2 and P-MODS for predicting prognosis of pediatric patients with sepsis in PICU were 0.761, 0.916 and 0.761, respectively( Z=6.127, 14.228, 4.688, all P<0.05). Conclusions:PCIS, PELOD-2 and P-MODS are effective and have good ability to assess the prognosis of pediatric patients with sepsis in the PICU.It seems that PELOD-2 is the most effective.
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Objective To explore the performance of early lactic acid measurement combined with Pediatric Critical Illness Score( PCIS)in evaluating the prognosis of children with sepsis in the Pediatric Intensive Care Unit (PICU). Methods The data of 516 pediatric patients in PICU of the Affiliated Hospital of Guangdong Medical Uni﹣versity from June 2016 to June 2018,diagnosed as sepsis were retrospectively analyzed. The patients were divided into survival group and non－survival group according to the clinical outcome of 28 days after admission. The variables of PCIS were collected and scored. Receiver operating characteristic curve(ROC curve)was drawn,and the efficiency of the early lactic acid measurement combined with PCIS for predicting death was evaluated by using the area under ROC curve(AUC). Results Of 516 pediatric patients with sepsis,238 cases(46. 1﹪)were common sepsis,262 cases (50. 8﹪)were severe sepsis,and 16 cases(3. 1﹪)were septic shock. Among them,488 cases(94. 6﹪)were pe﹣diatric patients survived,while 28 cases(5. 4﹪)did not survive during hospitalization. PCIS in non－survival group [86(82,88)scores]was significantly lower than that of survival group[92(86,96)scores]and the early lactic acid measurement was significantly increased[2. 8(1. 1,10. 3)mmol/L νs. 1. 2(0. 8,1. 9)mmol/L](Z ﹦3 259. 5, 9 953. 5,all P＜0. 05). ROC curve analysis showed that the AUCs of early lactic acid measurement,PCIS,early lactic acid measurement combined with PCIS for predicting prognosis of pediatric patients with sepsis in the PICU were 0. 728,0. 761 and 0. 829,respectively(Z﹦3. 744,6. 127,7. 759,all P＜0. 05). There was significant difference in the AUC between the early lactic acid measurement combined with PCIS and early lactic acid measurement,PCIS( Z ﹦2. 114,2. 122,all P＜0. 05). There was no significant difference in the AUC between the early lactic acid measurement and PCIS(Z﹦0. 480,P＞0. 05). Conclusions The early lactic acid measurement and PCIS are effective and able to assess the prognosis of pediatric patients with sepsis in the PICU. It also indicates that the early lactic acid measurement combined with PCIS is more effective.
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Objective@#To explore the performance of early lactic acid measurement combined with Pediatric Critical Illness Score (PCIS) in evaluating the prognosis of children with sepsis in the Pediatric Intensive Care Unit (PICU).@*Methods@#The data of 516 pediatric patients in PICU of the Affiliated Hospital of Guangdong Medical University from June 2016 to June 2018, diagnosed as sepsis were retrospectively analyzed.The patients were divided into survival group and non-survival group according to the clinical outcome of 28 days after admission.The variables of PCIS were collected and scored.Receiver operating characteristic curve (ROC curve) was drawn, and the efficiency of the early lactic acid measurement combined with PCIS for predicting death was evaluated by using the area under ROC curve (AUC).@*Results@#Of 516 pediatric patients with sepsis, 238 cases (46.1%) were common sepsis, 262 cases (50.8%) were severe sepsis, and 16 cases (3.1%) were septic shock.Among them, 488 cases (94.6%) were pe-diatric patients survived, while 28 cases (5.4%) did not survive during hospitalization.PCIS in non-survival group [86(82, 88) scores]was significantly lower than that of survival group [92(86, 96) scores]and the early lactic acid measurement was significantly increased[2.8(1.1, 10.3) mmol/L vs.1.2(0.8, 1.9) mmol/L](Z=3 259.5, 9 953.5, all P<0.05). ROC curve analysis showed that the AUCs of early lactic acid measurement, PCIS, early lactic acid measurement combined with PCIS for predicting prognosis of pediatric patients with sepsis in the PICU were 0.728, 0.761 and 0.829, respectively (Z=3.744, 6.127, 7.759, all P<0.05). There was significant difference in the AUC between the early lactic acid measurement combined with PCIS and early lactic acid measurement, PCIS(Z=2.114, 2.122, all P<0.05). There was no significant difference in the AUC between the early lactic acid measurement and PCIS(Z=0.480, P>0.05).@*Conclusions@#The early lactic acid measurement and PCIS are effective and able to assess the prognosis of pediatric patients with sepsis in the PICU.It also indicates that the early lactic acid measurement combined with PCIS is more effective.
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Objective@#To investigate the classification, prognosis and causes of acute gastrointestinal injury(AGI) in PICU patients in our hospital.@*Methods@#Patients were included if they had been hospitalized in PICU at least 24 h before the AGI diagnosis from January 2015 to April 2018.Patients were classified according to severity of gastrointestinal dysfunction.Clinical characteristics, pediatric critical illness scores, pediatric logistic organ dysfunction score 2 and 28-day mortality, as well as mechanical ventilation were recorded.@*Results@#A total of 220 patients were enrolled.AGIⅠ-Ⅳ groups included 66(30.0%), 97(44.1%), 37(16.8%)and 20(9.1%) patients, respectively, while primary AGI and secondary AGI included 149(67.7%) and 71 (32.3%)patients, respectively.There was no significant difference among four groups in gender, hospitalization time in PICU and total hospitalization time (P>0.05), but there were significant differences in median age, pediatric critical illness scores, pediatric logistic organ dysfunction score 2 and proportion of mechanical ventilation(P<0.05). Median age(month) was 3 (1, 15), 11 (2, 24), 11 (2, 36), and 4 (0.5, 11.5), respectively in AGI Ⅰ-Ⅳ groups.The total 28-day mortality rate of AGI Ⅰ-Ⅳ groups accounted for 0, 0, 13.2% and 3.2%, respectively.@*Conclusion@#Patients in PICU are prone to AGI.AGIⅠand AGI Ⅱare common.The prognosis is associated with classification of AGI.The higher grades of AGI are, the worse prognosis is.The prognosis of AGI Ⅲ is the worst, because of different causes.
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Objective To investigate the classification,prognosis and causes of acute gastrointestinal injury(AGI) in PICU patients in our hospital. Methods Patients were included if they had been hospitalized in PICU at least 24 h before the AGI diagnosis from January 2015 to April 2018. Patients were classified ac-cording to severity of gastrointestinal dysfunction. Clinical characteristics,pediatric critical illness scores,pedi-atric logistic organ dysfunction score 2 and 28-day mortality,as well as mechanical ventilation were recorded. Results A total of 220 patients were enrolled. AGIⅠ-Ⅳ groups included 66 ( 30. 0%),97 ( 44. 1%), 37(16. 8%) and 20 ( 9. 1%) patients, respectively, while primary AGI and secondary AGI included 149(67. 7%) and 71 (32. 3%)patients,respectively. There was no significant difference among four groups in gender,hospitalization time in PICU and total hospitalization time (P>0. 05),but there were significant differences in median age,pediatric critical illness scores,pediatric logistic organ dysfunction score 2 and pro-portion of mechanical ventilation(P<0. 05). Median age( month) was 3 (1,15),11 (2,24),11 (2,36), and 4 (0. 5,11. 5),respectively in AGI Ⅰ-Ⅳ groups. The total 28-day mortality rate of AGI Ⅰ-Ⅳ groups accounted for 0,0,13. 2% and 3. 2%,respectively. Conclusion Patients in PICU are prone to AGI. AGIⅠand AGI Ⅱare common. The prognosis is associated with classification of AGI. The higher grades of AGI are,the worse prognosis is. The prognosis of AGI Ⅲ is the worst,because of different causes.