Severity of Illness and Organ Dysfunction Scoring in Pediatric Intensive Care Unit: What News in 2016?

Abstract

Severity of illness and organ dysfunction scoring systems are increasingly used in adult and pediatric intensive care unit (PICU) to characterize disease severity and degree of organ dysfunction. In PICU, severity of illness scores are developed independently of diagnosis, taking into account the age of the different populations. Severity of illness scores were developed to better describe the severity of illness at baseline of groups of critically ill patients. Two systems are available: the pediatric index of mortality (PIM)—latest version PIM3 published in 2013, and the Pediatric RISk of Mortality (PRISM) system, which should be used in critically ill neonates, infants, children, or adolescents, (excluding premature infants)—latest version PRISM IV published in 2016. Organ dysfunction scores were developed to better describe the severity of illness during stay in the PICU. The Pediatric Logistic Organ Dysfunction score is the most commonly used pediatric organ dysfunction score—latest version PELOD-2 published in 2013. The purpose of this review is to provide an update about severity of illness and organ dysfunction scoring systems in PICU, to describe tools to evaluate performance and customization, and then discuss utility, limits and perspectives for scoring systems in PICU.