Severity of illness and organ dysfunction scoring in children.
OBJECTIVE
To describe predictive and descriptive general scores that can be used to estimate the severity of illness in critically ill children.


METHODS
Review of the medical literature.


METHODS
Pediatric intensive care units (PICUs).


METHODS
Critically ill children.


METHODS
None.


RESULTS
Two predictive scores are frequently used in PICUs: the Pediatric Risk of Mortality III score and the Pediatric Index of Mortality 2. The data considered in these scores are collected at baseline. Predictive scores can be used to compare expected and observed mortality in PICUs or to estimate the balance in the baseline severity of illness of patients included in the different arms of a randomized clinical trial. Only one descriptive score is validated to estimate the severity of cases of multiple organ dysfunction syndrome in PICUs, namely, the Pediatric Logistic Organ Dysfunction score. The data required to calculate this score are collected from baseline to discharge from the PICU or up to 2 hrs before death in the PICU. The Pediatric Logistic Organ Dysfunction score can be used to describe the clinical outcome of patients during their stay in a PICU.


CONCLUSIONS
Pediatric Risk of Mortality III, Pediatric Index of Mortality 2, and Pediatric Logistic Organ Dysfunction scores are the best available tools to estimate the severity of illness in critically ill children.
Lacroix
Jacques
J
Division of Pediatric Critical Care, Department of Pediatrics, Sainte-Justine Hospital, Université de Montréal, Montréal, Canada. jacques_lacroix@ssss.gouv.qc.ca
Cotting
Jacques
J
D002648:Child; D016638:Critical Illness; D006801:Humans; D015278:Intensive Care Units, Pediatric; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality; D012720:Severity of Illness Index