Table 2.
Inter-test reproducibility of two sets of diagnostic criteria of MODS in 842 consecutive PICU patients
| Diagnosis of MODS or organ dysfunction in 842 patients | |||||
|---|---|---|---|---|---|
| Proulx, patientsa | Goldstein patientsb | Concordancec | p value | Kappa scorec,d | |
| MODS during PICU stay | |||||
| 1. MODS at PICU admission | 124 (14.7 %) | 249 (29.6 %) | 81 % | <0.001 | 0.49 (0.43–0.56) |
| Progressive MODSe | 109 (12.9 %) | 104 (12.4 %) | 89 % | <0.001 | 0.50 (0.42–0.59) |
| 2. New MODS | 56 (6.7 %) | 65 (7.7 %) | 93 % | <0.001 | 0.50 (0.39–0.61) |
| MODS during PICU stay (1 + 2) | 180 (21.4 %) | 314 (37.3 %) | 80 % | <0.001 | 0.56 (0.50–0.61) |
| Organ dysfunction during PICU stay | |||||
| Respiratory | 317 (37.7 %) | 373 (44.3 %) | 92 % | <0.001 | 0.85 (0.81–0.88) |
| Cardiovascular | 125 (14.9 %) | 15 (1.8 %) | 86 % | <0.001 | 0.17 (0.09–0.25) |
| Haematological | 93 (11.1 %) | 122 (14.5 %) | 90 % | <0.001 | 0.55 (0.46–0.63) |
| Neurological | 150 (17.8 %) | 428 (50.8 %) | 67 % | <0.001 | 0.34 (0.30–0.39) |
| Gastrointestinal | 13 (1.5 %) | Not applicable | – | – | – |
| Hepatic | 65 (7.7 %) | 107 (12.7 %) | 93 % | <0.001 | 0.62 (0.54–0.71) |
| Renal | 23 (2.7 %) | 25 (3.0 %) | 99 % | <0.001 | 0.91 (0.83–0.99) |
95 % CI 95 % confidence interval
MODS multiple organ dysfunction syndrome, PICU paediatric intensive care unit
aDiagnostic criteria of MODS advocated by Proulx in 1996 [4]
bDiagnostic criteria of MODS advocated by Goldstein in 2005 [5, 6]
cConcordance and kappa score estimate whether a given organ dysfunction was diagnosed twice or not diagnosed twice by the same observer in the same patients (inter-tests reproducibility), using in the same patients the two sets of diagnostic criteria of Proulx and Goldstein
dAccording to Kramer [21], a kappa score is considered slight if <0.2, fair if between 0.2 and 0.4, moderate if between 0.4 and 0.6, substantial if between 0.6 and 0.8 and almost perfect if >0.8
eProgressive MODS can happen only in patients with MODS at PICU admission