PELOD-2 (Pediatric Logistic Organ Dysfunction-2)
Independent clinical validation: pending
Two independent clinical validators will be named here once review is complete.
How it is calculated
PELOD-2 total = sum of 10 organ-dysfunction items, range 0–33. Neurologic: Glasgow Coma Scale ≥ 11 → 0, 5–10 → 1, 3–4 → 4; pupils both fixed → 5 (both reactive → 0). Cardiovascular: lactate < 5 mmol/L → 0, 5–10.9 → 1, ≥ 11 → 4; mean arterial pressure (mmHg) is scored 0 / 2 / 3 / 6 against age-banded cutoffs (a descending cascade: ≥ the 0-point cutoff → 0, else ≥ the 2-point cutoff → 2, else ≥ the 3-point cutoff → 3, else → 6) for the six age bands 0–<1, 1–11, 12–23, 24–59, 60–143 and ≥ 144 months. Renal: serum creatinine (µmol/L) ≥ the age-band threshold → 2, else 0. Respiratory: PaO₂/FiO₂ ≤ 60 → 2 (> 60 → 0); PaCO₂ ≤ 58 mmHg → 0, 59–94 → 1, ≥ 95 → 3; invasive mechanical ventilation → 3 (none → 0). Hematologic: white-cell count ≤ 2 ×10⁹/L → 2 (> 2 → 0); platelets ≥ 142 ×10⁹/L → 0, 77–141 → 1, ≤ 76 → 2. All age-banded MAP and creatinine cutoffs are transcribed from Leteurtre 2013 (Table 6). A second output reports predicted in-hospital mortality = 1 ÷ (1 + e^−logit) × 100%, with logit = −6.61 + 0.47 × total (Leteurtre 2013).
Limitations and notes
PELOD-2 describes the severity of multiple-organ dysfunction; the authors frame it as a descriptor, not an individual mortality predictor. The predicted-mortality output is derived from the published logit (logit = -6.61 + 0.47 × score; probability = 1/(1 + exp(-logit))) and is a population-level association in the derivation cohort (France/Belgium, n=3,671, 6% mortality); it must not be read as an individual prognosis and requires recalibration before predictive use elsewhere. Each item uses the worst value in the scoring window; per the source an unmeasured variable is scored normal (0 points), so this tool requires every input and the caller must supply a normal value for anything not measured — a partial dataset can understate the score. Pupillary reaction is binary in the source (Both reactive = 0, Both fixed = 5); the paper gives NO point value for a unilateral fixed pupil [NEEDS SOURCE], so only 'Both fixed' scores here and unilateral findings need an explicit clinical-team rule. GCS is consumed only as a total-score band (3–4, 5–10, ≥11); the GCS instrument itself is external — verify descriptor-wording provenance wherever a GCS entry widget is built. MAP and creatinine thresholds are age-banded exactly as printed in Leteurtre 2013 Table 6. Context (not decision thresholds): observed in-PICU mortality rose with the number of dysfunctional organs (0→0.4%, 3→7.1%, 4→30.5%, 5→59.0%; Table 8), and the derivation-cohort predicted mortality is ≈0.1% at a total of 0, ≈1.4% at 5, ≈12.9% at 10, ≈60.8% at 15, ≈94.2% at 20 and ≈99.4% at 25.
Accepted input ranges
- Patient age — 0–216 months
- Glasgow Coma Scale (lowest) — 3–15
- Pupillary reaction
- Lactatemia — 0–30 mmol/L
- Mean arterial pressure — 0–200 mmHg
- Serum creatinine — 0–1500 µmol/L
- PaO₂/FiO₂ ratio — 0–600
- PaCO₂ — 10–200 mmHg
- Invasive mechanical ventilation
- White blood cell count — 0–100 10^9/L
- Platelet count — 0–1000 10^9/L
References
- Leteurtre S, Duhamel A, Salleron J, Grandbastien B, Lacroix J, Leclerc F; GFRUP. PELOD-2: an update of the PEdiatric logistic organ dysfunction score. Crit Care Med. 2013;41(7):1761–1773.PMID 23685639DOI 10.1097/CCM.0b013e31828a2bbd
- Leteurtre S, Duhamel A, Deken V, Lacroix J, Leclerc F; GFRUP. Daily estimation of the severity of organ dysfunctions in critically ill children by using the PELOD-2 score. Crit Care. 2015;19:324.PMID 26369662DOI 10.1186/s13054-015-1054-y
Version and changelog
v1.0.0 · Organ dysfunction
- 2026-07-25 v1.0.0 — Initial release: 10-item PELOD-2 total (0–33) with age-banded MAP/creatinine and the published mortality logit as a secondary output.