Application of Multiple Organ Dysfunction Scoring Systems in Children: Do Physicians Really Need Them?

Cover Page

Cite item

Full Text

Abstract

BACKGROUND: A review of the scientific data reveals a lack of publications analyzing the opinions of anesthesiologists and intensivists in pediatric departments of anesthesiology, resuscitation, and intensive care on the necessity of using organ dysfunction severity scoring systems in clinical practice.

AIM: The study aimed to analyze the opinions of anesthesiologists and intensivists working in pediatric departments of anesthesiology, resuscitation, and intensive care in the Russian Federation regarding the necessity of applying multiple organ dysfunction scoring systems in clinical practice.

METHODS: The study was observational, uncontrolled, and based on a voluntary anonymous survey conducted through the website of the Association of Pediatric Anesthesiologists and Intensivists of Russia. Descriptive statistics were presented as frequencies and percentages; responses to open-ended questions were categorized based on key qualitative parameters. Pearson’s χ2 test was used for comparative analysis of categorical data.

RESULTS: A total of 230 respondents participated in the survey, the majority of them were physicians from regional clinical hospitals (38.7%) with over 10 years of experience (69.6%). The most well-known and frequently used scoring systems were qSOFA, nSOFA, NEOMOD, pSOFA, and the Phoenix Sepsis Score. Regular use of multiple organ dysfunction severity scores was reported by 77 (33.5%) respondents, with the most commonly applied being the qSOFA scale, which has not been validated in the Russian clinical settings.

CONCLUSION: More than 60% of pediatric anesthesiologists and intensivists use multiple organ dysfunction scoring systems irregularly, and their use is more commonly driven by the perceived high risk of mortality than by the need to determine subsequent treatment strategies.

About the authors

Petr I. Mironov

Bashkir State Medical University

Author for correspondence.
Email: mironovpi@mail.ru
ORCID iD: 0000-0002-9016-9461
SPIN-code: 5617-6616

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ufa

Yuri S. Alexandrovich

Saint Petersburg State Pediatric Medical University

Email: jalex1963@mail.ru
ORCID iD: 0000-0002-2131-4813
SPIN-code: 2225-1630

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Sergey M. Stepanenko

Pirogov Russian National Research Medical University

Email: steven54@mail.ru
ORCID iD: 0000-0001-5985-4869
SPIN-code: 1046-9206

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Konstantin V. Pshenisnov

Saint Petersburg State Pediatric Medical University

Email: Psh_K@mail.ru
ORCID iD: 0000-0003-1113-5296
SPIN-code: 8423-4294

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Saint Petersburg

Anton V. Trembach

Kuban State Medical University

Email: trembach@bk.ru
ORCID iD: 0000-0002-4968-5296
SPIN-code: 4396-6261
Russian Federation, Krasnodar

References

  1. Cohen IB. Florence nightingale. Sci Am. 1984;250(3):128–137. doi: 10.1038/scientificamerican0384-128
  2. Karimi H, Masoudi Alavi N. Florence nightingale: The mother of nursing. Nurs Midwifery Stud. 2015;4(2):29475. doi: 10.17795/nmsjournal29475
  3. Alexandrovich YS, Gordeev VI. Evaluation and prognostic scales in critical care medicine. Saint Petersburg: Sotis; 2020. 320 p. (In Russ.)
  4. Vincent J-L, Moreno R. Clinical review: scoring systems in the critically ill. Crit Care. 2010;14(2):207. doi: 10.1186/cc8204
  5. Schlapbach LJ, Straney L, Bellomo R, et al. 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. Int Care Med. 2018;44(2):179–188. doi: 10.1007/s00134-017-5021-8
  6. Weiss SL, Fitzgerald JC, Pappachan J, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med. 2015;191(10):1147–115. doi: 10.1164/rccm.201412-2323OC
  7. Schlapbach LJ, Watson RS, Sorce LR, et al. International consensus criteria for pediatric sepsis and septic shock. JAMA. 2024;331(8):665–674. doi: 10.1001/jama.2024.017914
  8. Hikmet N, Chen SK. An investigation into low mail survey response rates of information technology users in health care organizations. Int J Med Inform. 2003;72(1-3):29–34. doi: 10.1016/j.ijmedinf.2003.09.002
  9. Romaine ST, Potter J, Khanijau A, et al. Accuracy of a modified qSOFA score for predicting critical care admission in febrile children. Pediatrics. 2020;146(4):e20200782. doi: 10.1542/peds.2020-0782
  10. van Nassau SC, van Beek RH, Driessen GJ, et al. Translating sepsis-3 criteria in children: prognostic accuracy of age-adjusted quick SOFA score in children visiting the emergency department with suspected bacterial infection. Front Pediatr. 2018;6:266. doi: 10.3389/fped.2018.00266

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. Awareness of multiple organ dysfunction scoring systems in children and frequency of their use in clinical practice (n = 230).

Download (43KB)
3. Fig. 2. Perceived reliability of multiple organ dysfunction scoring systems in children according to respondents (n = 230).

Download (40KB)

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).