Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/17041
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dc.contributor.authorSchlapbach, Luregn J-
dc.contributor.authorStraney, Lahn-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorMacLaren, Graeme-
dc.contributor.authorPilcher, David-
dc.date2017-12-19-
dc.date.accessioned2018-01-11T22:50:40Z-
dc.date.available2018-01-11T22:50:40Z-
dc.date.issued2018-02-
dc.identifier.citationIntensive Care Medicine 2017; 44(2): 179-188en_US
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/17041-
dc.description.abstractPURPOSE: The 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. METHODS: We 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. RESULTS: Of 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). CONCLUSIONS: SIRS 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.en_US
dc.subjectChildhooden_US
dc.subjectCritical careen_US
dc.subjectInfectionen_US
dc.subjectMortalityen_US
dc.subjectPELODen_US
dc.subjectSIRSen_US
dc.subjectSOFAen_US
dc.subjectScoresen_US
dc.subjectSepsisen_US
dc.titlePrognostic accuracy of age-adapted SOFA, SIRS, PELOD-2, and qSOFA for in-hospital mortality among children with suspected infection admitted to the intensive care uniten_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleIntensive Care Medicineen_US
dc.identifier.affiliationFaculty of Medicine, The University of Queensland, Brisbane, Australiaen_US
dc.identifier.affiliationPaediatric Critical Care Research Group, Mater Research Institute, The University of Queensland, Brisbane, Australiaen_US
dc.identifier.affiliationPaediatric Intensive Care Unit, Lady Cilento Children's Hospital, Children's Health Queensland, Brisbane, Australiaen_US
dc.identifier.affiliationDepartment of Pediatrics, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerlanden_US
dc.identifier.affiliationUniversity of Melbourne, Melbourne, Australiaen_US
dc.identifier.affiliationIntensive Care, Austin Health, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationCardiothoracic Intensive Care Unit, National University Health System, Singapore, Singaporeen_US
dc.identifier.affiliationPaediatric Intensive Care Unit, The Royal Children's Hospital, Melbourne, Australiaen_US
dc.identifier.affiliationThe Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation (CORE), ANZICS House, Levers Terrace, Carlton South, Melbourne, Australiaen_US
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australiaen_US
dc.identifier.affiliationDepartment of Intensive Care, The Alfred Hospital, Commercial Road, Prahran, Victoria, Australiaen_US
dc.type.studyortrialCohort Studyen_US
dc.identifier.pubmedurihttps://pubmed.ncbi.nlm.nih.gov/29256116en_US
dc.identifier.doi10.1007/s00134-017-5021-8en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-1650-8939-
dc.type.austinJournal Articleen_US
local.name.researcherBellomo, Rinaldo
item.cerifentitytypePublications-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
Appears in Collections:Journal articles
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