Assessment of Admission Pelod-2 Score as a Predictor of Mortality at a Tertiary Paediatric Critical Care Unit in a Low-middle Income Country.

Abstract

Background Paediatric Logistic Organ Dysfunction 2 (PELOD-2) score is a scoring system that has been used to show that Multiple Organ Dysfunction System is a predictor of duration of Paediatric Critical Care Unit (PCCU) stay, severity of illness and mortality with good validity. No studies have been done in East Africa to assess the relationship between admission PELOD-2 score and mortality and its association with length of PCCU stay. Broad Objectives: To assess the relationship between admission PELOD-2 score and mortality and to assess the relationship between admission PELOD-2 score and length of stay in a PCCU in a low-middle income country. Methodology: Study design: Retrospective observational study. Study site/setting: Paediatric Critical Care Unit (PCCU) and main Intensive Care Unit (ICU) at Kenyatta National Hospital. Study population: Children aged 1 month to 13 years admitted at the PCCU and main ICU at Kenyatta National Hospital. Study procedure: Data was abstracted from medical records of all patients who met eligibility criteria, from February 2019 to December 2020, until we realized the desired number of patients with the event of interest (100 events(deaths). Patient’s biodata, clinical data, survival data, duration of stay in PCCU and PELOD-2 scores were abstracted from patient files into a predesigned data collection sheet. PELOD-2 scores were calculated from the 10 variables at admission to the PCCU or main ICU. 13

Data Management and Analysis: Categorical data was summarized using proportions and tabulated with frequency tables. Chi-square test was used to explore any association between the categorical variables. Descriptive statistics such as median and interquatile range were used for continuous variables and Mann Whitney statistics was used to analyse this data. The assessment of the association between PELOD-2 sore and mortality was determined by carrying out discrimination and calibration tests. Secondary outcome variable was to compare admission PELOD-2 scores viz a viz length of PCCU stay (LOPS). This data underwent validity testing through discrimination and calibration testing. Study Utility PELOD-2 score can be used as a predictor of severity of illness, mortality, length of PCCU stay and functional outcomes. This data will inform resource allocation for better patient care and outcomes.