perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2020-65-5-37-41perinatology-1233Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESПрогностическая значимость шкал pSOFA и PELOD 2 в отношении риска летального исхода у пациентов неонатальных отделений интенсивной терапииPrognostic value of the pSOFA and PELOD 2 scales in assessing the risk of death in neonatal intensive care unitshttps://orcid.org/0000-0002-5219-9985КудиноваГ. А.KudinavaG. A.

Кудинова Гузель Амировна — заведующий отделением.

450106 Уфа, улица Степана Кувыкина, д. 98

Ufa

https://orcid.org/0000-0002-9016-9461МироновП. И.MironovP. I.

Миронов Петр Иванович — доктор медицинских наук, профессор кафедры детской хирургии.

450008 Уфа, ул. Ленина, д. 3

Ufa

mironovpi@mail.ruhttps://orcid.org/0000-0003-0798-1625ЛекмановА. У.LekmanovA. U.

Лекманов Андрей Устинович — доктор медицинских наук, профессор, главный научный сотрудник отдела хирургии детского возраста.

117997 Москва, ул. Островитянова, д. 1

Moscow

ГБУЗ Республиканская детская клиническая больница Минздрава Республики БашкортостанРоссияRepublican Children's Clinical HospitalRussian FederationФГБОУ ВО Башкирский государственный медицинский университет Минздрава РоссииРоссияBashkortostan State Medical UniversityRussian FederationНаучно-исследовательский институт клинической хирургии, ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияPirogov Research Institute of Clinical SurgeryRussian Federation2020181120206553741Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20202020Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1233Цель исследования

Цель исследования. Оценка дискриминационной способности шкал PELOD 2 и pSOFA в условиях многопрофильного неонатального отделения интенсивной терапии.

Материал и методы

Материал и методы. Дизайн исследования — проспективное, обсервационное, одноцентровое. Конечные точки — оценка тяжести состояния по шкалам PELOD 2 и pSOFA; 28-дневная выживаемость. В разработку включен 121 пациент.

Результаты

Результаты. Исследование дискриминационной мощности шкал показало, что все они имеют хорошее качество модели. В то же время оценочная система pSOFA обладает статистически значимо большей (р<0,05) площадью под ROC-кривой (0,903±0,09). Проведенный анализ не обнаружил достоверных различий по характеристики суррогатных конечных точек между сравниваемыми шкалами при сопоставимых точках разделения риска смерти (р<0,05).

Заключение

Заключение. Высокая дискриминационная способность шкалы pSOFA позволяет рекомендовать ее для клинического использования в условиях неонатальных отделений интенсивной терапии.

Objective

Objective. To assess the discriminatory ability of the PELOD 2 and pSOFA scales in the conditions of multidisciplinary neonatal intensive care unit.

Material and methods

Material and methods. It is a prospective, observational, single-center study. The end points are to assess the severity of the condition on the PELOD 2 and pSOFA scales; 28-day survival. The study includes 121 patients.

Results

Results. While studying the discriminating power of the scales we have found that all scales have good model quality. At the same time, the pSOFA evaluation system has a statistically more significant (p<0.05) area under the ROC curve (0.903±0.09). Our analysis has not found significant differences in the characteristics of surrogate endpoints between the compared scales in the conditions of comparable points of separation of death risks (p<0.05).

Conclusion

Conclusion. The high discrimination ability of the pSOFA scale allows us to recommend it for clinical use in neonatal intensive care units.

новорожденныетяжесть состоянияшкалы pSOFAPELOD 2валидностьnewbornsseverity of the conditionpSOFA and PELOD 2 scalesvalidityReferencesPinto N.P., Rhinesmith E.W., Kim T.Y., Ladner P.H., Pollack M.M. Long-term function after pediatric critical illness: Results from the survivor outcomes study. Pe-diatr Crit Care Med 2017; 18: e122-e130 doi: 10.1097/PCC.0000000000001070.Pinto N.P., Rhinesmith E.W., Kim T.Y., Ladner P.H., Pollack M.M. Long-term function after pediatric critical illness: Results from the survivor outcomes study. Pe-diatr Crit Care Med 2017; 18: e122-e130 doi: 10.1097/PCC.0000000000001070.Pollack M.M., Holubkov R, Funai T., Amy C., John B.T., Kathleen M. et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network: Pediatric intensive care outcomes: Development of new morbidities during pediatric critical care. Pediatr Crit Care Med 2014; 15: 821—827. DOI: 10.1097/PCC.0000000000000250Pollack M.M., Holubkov R, Funai T., Amy C., John B.T., Kathleen M. et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network: Pediatric intensive care outcomes: Development of new morbidities during pediatric critical care. Pediatr Crit Care Med 2014; 15: 821—827. DOI: 10.1097/PCC.0000000000000250Pollack M.M., Holubkov R, Funai T., Amy C., John B.T., Kathleen M. et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network: Simultaneous prediction of new morbidity, mortality, and survival without new morbidity from pediatric intensive care: A new paradigm for outcomes assessment. Crit Care Med 2015; 43: 1699—1709. DOI: 10.1097/CCM.0000000000001081Pollack M.M., Holubkov R, Funai T., Amy C., John B.T., Kathleen M. et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network: Simultaneous prediction of new morbidity, mortality, and survival without new morbidity from pediatric intensive care: A new paradigm for outcomes assessment. Crit Care Med 2015; 43: 1699—1709. DOI: 10.1097/CCM.0000000000001081Ferreira A.M., Sakr Y. Organ dysfunction: General approach, epidemiology, and organ failure scores. Semin Respir Crit Care Med 2011; 32: 543-551. DOI: 10.1055/s-0031-1287862Ferreira A.M., Sakr Y. Organ dysfunction: General approach, epidemiology, and organ failure scores. Semin Respir Crit Care Med 2011; 32: 543-551. DOI: 10.1055/s-0031-1287862Leteurtre S, Duhamel A., Salleron J., Grandbastien B., Lacroix J., Leclerc F. Groupe Francophone de Reanimation et d’Urgences Pediatriques (GFRUP): PELOD-2: An update of the PEdiatric logistic organ dysfunction score. Crit Care Med 2013; 41: 1761-1773. DOI: 10.1097/CCM.0b013e-31828a2bbdLeteurtre S, Duhamel A., Salleron J., Grandbastien B., Lacroix J., Leclerc F. Groupe Francophone de Reanimation et d’Urgences Pediatriques (GFRUP): PELOD-2: An update of the PEdiatric logistic organ dysfunction score. Crit Care Med 2013; 41: 1761-1773. DOI: 10.1097/CCM.0b013e-31828a2bbdMatics T.J., Sanchez-Pinto L.N. Adaptation and validation of a pediatric sequential organ failure assessment score and evaluation of the Sepsis-3 definitions in critically ill children. JAMA Pediatr 2017; 171: e172352. DOI: 10.1001/jamapedi-atrics.2017.2352Matics T.J., Sanchez-Pinto L.N. Adaptation and validation of a pediatric sequential organ failure assessment score and evaluation of the Sepsis-3 definitions in critically ill children. JAMA Pediatr 2017; 171: e172352. DOI: 10.1001/jamapedi-atrics.2017.2352Leteurtre S., Martinot A., Duhamel A., Gauvin F, Grandbastien B., Nam T.V. et al. Development of a pediatric multiple organ dysfunction score: Use of two strategies. Med Decis Making 1999; 19: 399-410. DOI: 10.1177/0272989X9901900408Leteurtre S., Martinot A., Duhamel A., Gauvin F, Grandbastien B., Nam T.V. et al. Development of a pediatric multiple organ dysfunction score: Use of two strategies. Med Decis Making 1999; 19: 399-410. DOI: 10.1177/0272989X9901900408Azoulay E., Vincent J.L., Angus D.C., Arabi Y.M., Brochard L., Brett S.J., Citerio G. et al. Recovery after critical illness: Putting the puzzle together-a consensus of 29. Crit Care 2017; 21: 296. DOI: 10.1186/s13054-017-1887-7Azoulay E., Vincent J.L., Angus D.C., Arabi Y.M., Brochard L., Brett S.J., Citerio G. et al. Recovery after critical illness: Putting the puzzle together-a consensus of 29. Crit Care 2017; 21: 296. DOI: 10.1186/s13054-017-1887-7Schlapbach L.J., Straney L, Bellomo R., MacLaren G., Pilcher D. 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. Intensive Care Med 2018; 44: 179-188. DOI: 10.1007/s00134-017-5021-8Schlapbach L.J., Straney L, Bellomo R., MacLaren G., Pilcher D. 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. Intensive Care Med 2018; 44: 179-188. DOI: 10.1007/s00134-017-5021-8Schlapbach L.J., Kissoon N. Defining pediatric sepsis. JAMA Pediatr 2018; 172: 312-314. DOI: 10.1001/jamapediat-rics.2017.5208Schlapbach L.J., Kissoon N. Defining pediatric sepsis. JAMA Pediatr 2018; 172: 312-314. DOI: 10.1001/jamapediat-rics.2017.5208Kawasaki T., Shime N., Straney L., Bellomo R., MacLaren G., Pilcher D. et al. Paediatric sequential organ failure assessment score (pSOFA): a plea for the world-wide collaboration for consensus. Intensive Care Med 2018; 44(6): 995-997. DOI: 10.1007/s00134-018-5188-7Kawasaki T., Shime N., Straney L., Bellomo R., MacLaren G., Pilcher D. et al. Paediatric sequential organ failure assessment score (pSOFA): a plea for the world-wide collaboration for consensus. Intensive Care Med 2018; 44(6): 995-997. DOI: 10.1007/s00134-018-5188-7Matics T.J., Pinto N.P., L. Sanchez-Pinto N. Association of Organ Dysfunction Scores and Functional Outcomes Following Pediatric Critical Illness Pediatr Crit Care Med 2019; 20(8): 722-727. DOI: 10.1097/PCC.0000000000001999Matics T.J., Pinto N.P., L. Sanchez-Pinto N. Association of Organ Dysfunction Scores and Functional Outcomes Following Pediatric Critical Illness Pediatr Crit Care Med 2019; 20(8): 722-727. DOI: 10.1097/PCC.0000000000001999Leteurtre S., Martinot A., Duhamel A., Proulx F., Grandbastien B., Cotting J. et al. Validation of the paediatric logistic organ dysfunction (PELOD) score. Prospective, observation, multicenter study. Lancet 2003; 362: 192. DOI: 10.1016/S0140-6736(03)13908-6Leteurtre S., Martinot A., Duhamel A., Proulx F., Grandbastien B., Cotting J. et al. Validation of the paediatric logistic organ dysfunction (PELOD) score. Prospective, observation, multicenter study. Lancet 2003; 362: 192. DOI: 10.1016/S0140-6736(03)13908-6TyppoK., Watson R.S., Bennett T.D., FarrisR.W.D. Outcomes of Day 1 Multiple Organ Dysfunction Syndrome in the PICU. Pediatr Crit Care Med 2019; 20: 914-922. DOI: 10.1097/PCC.0000000000002044TyppoK., Watson R.S., Bennett T.D., FarrisR.W.D. Outcomes of Day 1 Multiple Organ Dysfunction Syndrome in the PICU. Pediatr Crit Care Med 2019; 20: 914-922. DOI: 10.1097/PCC.0000000000002044Хаертынов Х.С, Анохин В.А., Халиуллина С.В. Любин С.А., Донцова Н.В, Королева П.В. и др. Клинико-эпидемиологические особенности и органная дисфункция при неонатальном сепсисе. Российский вестник перинатологии и педиатрии 2019; 64(5): 176-182. DOI: 10.21508/1027-4065-2019-64-5-176-182Khaertynov Kh.S., Anokhin V.A., Khaliullina S.V., Lubin S.A., Doncova N.V., Koroleva P.V. et al. Clinical and epidemiological features and organ dysfunction in newborns with neonatal sepsis. Rossiys-kiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 2019; 64(5): 176-182. (in Russ). DOI: 10.21508/1027-4065-2019-64-5-176-182Hsu H. E., Abanyie F., Agus M.S.D., Balamuth F., Brady P.W., Brilli R.G. et al. A National Approach to Pediatric Sepsis Surveillance. PEDIATRICS 2019; 144 (6): e20191790. DOI: 10.1542/peds.2019-1790Hsu H. E., Abanyie F., Agus M.S.D., Balamuth F., Brady P.W., Brilli R.G. et al. A National Approach to Pediatric Sepsis Surveillance. PEDIATRICS 2019; 144 (6): e20191790. DOI: 10.1542/peds.2019-1790

The authors declare that there are no conflicts of interest present.