Abstract
The PEdiatric Logistic Organ Dysfunction (PELOD) score has been validated as a score to describe and quantify the severity of organ dysfunctions (ODs). Several neonatal pathophysiological and immunological particularities make a rationale for differences in ODs between neonates and other children (non-neonates).
Objective: To find out if there are important differences in mortality, OD incidence and OD contribution to mortality between neonates (age< 28 days) and non-neonates, using the PELOD score.
Methods: Prospective, observational study in seven PICUs of university-affiliated hospitals (09/98 - 02/2000). No intervention was done.
Results: 1806 patients were included, 171 (9.5%) were full-term neonates. Mortality rate and incidence of MODS were higher in neonates than in nonneonates (14.6% vs. 5.5%, p< 10-7; 75.4%, vs.50.9%, p< 10-4 respectively). Daily PELOD (dPELOD) scores were significantly higher in neonates from day 1 to day 4. Daily cardiovascular, respiratory and renal dysfunction scores from day 1 to day 4, and the entire stay dysfunction scores of these three organs were significantly higher in neonates than in non-neonates. The ODs that significantly contributed to mortality in neonates were neurological, cardiovascular, and hepatic dysfunctions. In non-neonates, all ODs significantly contributed to mortality.
Conclusion: Our data demonstrate that mortality in neonates was higher as compared with nonneonates. Neurological, cardiovascular, and hepatic dysfunctions were the only significant contributors to neonatal mortality, while other ODs were also associated with mortality in non-neonates.
(PELOd group: we thank Jacques Cotting, Ronald Gottesman, Ari Joffe, Bendicht Wagner, Philippe Hubert, Alain Martinot for their contribution in data collection).
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Leteurtre, S., Bestati, N., Duhamel, A. et al. 1218 Differences in Organ Dysfunctions Between Neonates and Other Children. Pediatr Res 68 (Suppl 1), 603 (2010). https://doi.org/10.1203/00006450-201011001-01218
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DOI: https://doi.org/10.1203/00006450-201011001-01218