Relationship between risk-adjustment tools and the pediatric logistic organ dysfunction score. World J Pediatr Congenit Heart Surg 2014 Jan 01;5(1):16-21
Date
01/10/2014Pubmed ID
24403350DOI
10.1177/2150135113510008Scopus ID
2-s2.0-84907616904 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
BACKGROUND: The Risk-Adjusted Classification for Congenital Heart Surgery (RACHS-1) method and Aristotle Basic Complexity (ABC) scores correlate with mortality. However, low mortality rates in congenital heart disease (CHD) make use of mortality as the primary outcome measure insufficient. Demonstrating correlation between risk-adjustment tools and the Pediatric Logistic Organ Dysfunction (PELOD) score might allow for risk-adjusted comparison of an outcome measure other than mortality.
METHODS: Data were obtained from the Virtual PICU Systems database. Patients with postoperative CHD between 2009 and 2010 were included. Correlation between RACHS-1 category and PELOD score and between ABC level and PELOD score was examined using Spearman rank correlation. Consistency of PELOD scores across institutions for given levels of case complexity was examined using Kruskal-Wallis nonparametric analysis of variance.
RESULTS: A total of 1,981 patient visits among 12 institutions met inclusion criteria. Positive correlations between PELOD score and RACHS-1 category (r s = .353, P < .0001) as well as between PELOD score and ABC level (r s = .328, P < .0001) were demonstrated. Variability in PELOD scores across individual centers for given levels of case complexity was observed (P < .04).
CONCLUSIONS: Risk-Adjusted Classification for Congenital Heart Surgery categories and ABC levels correlate with postoperative organ dysfunction as measured by PELOD. However, the correlation was weak, potentially due to limitations of the PELOD score itself. Identification of a more accurate metric of morbidity for the congenital heart disease population is needed.
Author List
Russell RA, Ghanayem NS, Kuhn EM, Jeffries HE, Scanlon MC, Rice TBAuthor
Matthew C. Scanlon MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Cardiac Surgical ProceduresChild
Data Collection
Heart Defects, Congenital
Hospital Mortality
Humans
Length of Stay
Organ Dysfunction Scores
Predictive Value of Tests
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
United States