Pediatric Multiple Organ Dysfunction Score (PEMOD) System

Description

Leteurtre et al developed the PEdiatric Multiple Organ Dysfunction (PEMOD) scoring system for evaluating critically ill children in pediatric ICUs. It evaluates 6 key organ systems with each represented by a single clinical or laboratory measure. This can be used to estimate the mortality risk for the child. The authors are from multiple institutions in Lille, Montreal and Paris.

The 6 organ systems with the 6 measures:

(1) neurologic (Glasgow Coma Score, or GCS)

(2) cardiovascular (systolic blood pressure)

(3) renal (serum creatinine)

(4) pulmonary (PaO2 to FIO2 ratio)

(5) hematologic (platelet count)

(6) hepatic (SGOT = AST)

If a parameter is measured more than once in a 24 hour period, then the most abnormal value is used to calculate the score. If the patient is sedated, the estimated GCS prior to sedation is used.

Organ System	Finding	Points
Glasgow Coma Score	12 - 15	0
	10 - 11	1
	8 – 9	2
	6 – 7	3
	3 - 5	4
systolic blood pressure	age < 1 month and SBP > 64 mm Hg	0
	age < 1 month and SBP 60-64 mm Hg	1
	age < 1 month and SBP 53-59 mm Hg	2
	age < 1 month and SBP 44-52 mm Hg	3
	age < 1 month and SBP <= 43 mm Hg	4
	age >= 1 month and < 1 year and SBP > 73 mm Hg	0
	age >= 1 month and < 1 year and SBP 67-73 mm Hg	1
	age >= 1 month and < 1 year and SBP 58-66 mm Hg	2
	age >= 1 month and < 1 year and SBP 45-57 mm Hg	3
	age >= 1 month and < 1 year and SBP <= 44 mm Hg	4
	age >= 1 year and < 12 years and SBP > 82 mm Hg	0
	age >= 1 year and < 12 years and SBP 77-82 mm Hg	1
	age >= 1 year and < 12 years and SBP 70-76 mm Hg	2
	age >= 1 year and < 12 years and SBP 58-69 mm Hg	3
	age >= 1 year and < 12 years and SBP <= 57 mm Hg	4
	age >= 12 years and SBP > 93 mm Hg	0
	age >= 12 years and SBP 88-93 mm Hg	1
	age >= 12 years and SBP 79-87 mm Hg	2
	age >= 12 years and SBP 67-78 mm Hg	3
	age >= 12 years and SBP <= 66 mm Hg	4
serum creatinine	age < 7 days and creatinine < 1.14 mg/dL	0
	age < 7 days and creatinine 1.14 - 2.38 mg/dL	1
	age < 7 days and creatinine 2.39 – 3.96 mg/dL	2
	age < 7 days and creatinine 3.97 – 5.77 mg/dL	3
	age < 7 days and creatinine > 5.77 mg/dL	4
	age >= 7 days and < 1 year and creatinine < 0.46 mg/dL	0
	age >= 7 days and < 1 year and creatinine 0.46 – 0.79 mg/dL	1
	age >= 7 days and < 1 year and creatinine 0.80 – 1.13 mg/dL	2
	age >= 7 days and < 1 year and creatinine 1.14 – 1.59 mg/dL	3
	age >= 7 days and < 1 year and creatinine > 1.59 mg/dL	4
	age >= 1 year and < 12 years and creatinine < 0.80 mg/dL	0
	age >= 1 year and < 12 years and creatinine 0.80 – 1.59 mg/dL	1
	age >= 1 year and < 12 years and creatinine 1.60 – 2.72 mg/dL	2
	age >= 1 year and < 12 years and creatinine 2.73 – 3.96 mg/dL	3
	age >= 1 year and < 12 years and creatinine > 3.96 mg/dL	4
	age >= 12 years and creatinine < 1.14 mg/dL	0
	age >= 12 years and creatinine 1.14 – 2.38 mg/dL	1
	age >= 12 years and creatinine 2.39 – 3.96 mg/dL	2
	age >= 12 years and creatinine 3.97 – 5.89 mg/dL	3
	age >= 12 years and creatinine > 5.89 mg/dL	4
PaO2 to FIO2 ratio	> 300	0
	226 – 300	1
	151 – 225	2
	76 – 150	3
	<= 75	4
platelet count	> 120,000 per µL	0
	81,000 – 120,000 per µL	1
	51,000 – 80,000 per µL	2
	26,000 – 50,000 per µL	3
	<= 25,000 per µL	4
SGOT (AST)	<= 30 IU/L	0
	31 – 100 IU/L	1
	101 – 250 IU/L	2
	251 – 800 IU/L	3
	> 800 IU/L	4

from Table 3, page 403

PEMOD score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 24

• The higher the score, the greater the mortality.

X =

= (0.38 * (PEMOD score)) – 4.67

probability of mortality =

= 1 / (1 + EXP((-1) * X))

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Description

Specialty

Objective

ICD-10

Pediatric Multiple Organ Dysfunction (PEMOD) System

Purpose: To predict the mortality of a pediatric patient requiring intensive care using the PEMOD system.

Description

Specialty

Objective

ICD-10