Evidence map›Paper›PMID 29256116›Full record

ArticleIntensive care medicine2018

Prognostic accuracy of age-adapted SOFA, SIRS, PELOD-2, and qSOFA for in-hospital mortality among children with suspected infection admitted to the intensive care unit.

Luregn J Schlapbach, Lahn Straney, Rinaldo Bellomo, Graeme MacLaren, David Pilcher

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In one paragraph

Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 143 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
143citing papers in PubMed, 8 pooled it
17.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

143 citing papers in PubMed, 8 syntheses or guidelines pooled it, 303 citations in OpenAlex.

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83 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 5 institutions in 3 countries.

Luregn J SchlapbachFaculty of Medicine, The University of Queensland, Brisbane, Australia. l.schlapbach@uq.edu.au.ORCID http://orcid.org/0000-0003-2281-2598
Lahn StraneyDepartment of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Rinaldo BellomoUniversity of Melbourne, Melbourne, Australia.
Graeme MacLarenUniversity of Melbourne, Melbourne, Australia.
David PilcherThe Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation (CORE), ANZICS House, Levers Terrace, Carlton South, Melbourne, Australia.
Royal Children's Hospital · AUThe Alfred Hospital · AUThe University of Melbourne · AUThe University of Queensland · AUUniversity of Bern · CH

Funding

Australian National Health and Medical Research Council 0606978
6 · The paper itself

Abstract

purposeThe Sepsis-3 consensus task force defined sepsis as life-threatening organ dysfunction caused by dysregulated host response to infection. However, the clinical criteria for this definition were neither designed for nor validated in children. We validated the performance of SIRS, age-adapted SOFA, quick SOFA and PELOD-2 scores as predictors of outcome in children.

methodsWe performed a multicentre binational cohort study of patients < 18 years admitted with infection to ICUs in Australia and New Zealand. The primary outcome was ICU mortality. SIRS, age-adapted SOFA, quick SOFA and PELOD-2 scores were compared using crude and adjusted area under the receiver operating characteristic curve (AUROC) analysis.

resultsOf 2594 paediatric ICU admissions due to infection, 151 (5.8%) children died, and 949/2594 (36.6%) patients died or experienced an ICU length of stay ≥ 3 days. A ≥ 2-point increase in the individual score was associated with a crude mortality increase from 3.1 to 6.8% for SIRS, from 1.9 to 7.6% for age-adapted SOFA, from 1.7 to 7.3% for PELOD-2, and from 3.9 to 8.1% for qSOFA (p < 0.001). The discrimination of outcomes was significantly higher for SOFA (adjusted AUROC 0.829; 0.791-0.868) and PELOD-2 (0.816; 0.777-0.854) than for qSOFA (0.739; 0.695-0.784) and SIRS (0.710; 0.664-0.756).

conclusionsSIRS criteria lack specificity to identify children with infection at substantially higher risk of mortality. We demonstrate that adapting Sepsis-3 to age-specific criteria performs better than Sepsis-2-based criteria. Our findings support the translation of Sepsis-3 into paediatric-specific sepsis definitions and highlight the importance of robust paediatric organ dysfunction characterization.

Indexed as

Hospital MortalityOrgan Dysfunction ScoresSepsisAdolescentAustraliaChildChild, PreschoolHumansInfantIntensive Care UnitsNew ZealandPrognosisProspective StudiesRetrospective StudiesSystemic Inflammatory Response SyndromeChildhoodCritical careInfectionMortalityPELODScoresSepsisSIRSSOFA

Identifiers

PMID29256116
PMCPMC5816088
OpenAlexW2779809707

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.