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Star Research Presentations: Pediatric Public Health and Epidemiology

Evaluating Predictive Performance of Pediatric Logistic Organ Dysfunction-2 Score in Trauma Patients

Sunday, March 22, 2026
10:45 AM - 11:35 AM Central Time
Location: Connections Central Theater 2
  • AK

    Anne Kalinowski, MD

    Childrens Hospital of Pittsburgh of UPMC

    Disclosure(s): No relevant financial relationship(s) to disclose.

  • CL

    Christine Leeper, MD, MSc

    Assistant Professor of Surgery and Critical Care Medicine
    UPMC Presbyterian

    Disclosure information not submitted.

  • EF

    Ericka Fink, MD, FCCM

    UPMC Children's Hospital of Pittsburgh, Pennsylvania

    Disclosure information not submitted.

  • CH

    Christopher Horvat, MD, MHA

    University of Pittsburgh, Pennsylvania

    Disclosure information not submitted.

  • PS

    Philip Spinella, MD

    Professor of Surgery and Critical Care Medicine
    University of Pittsburgh

    Disclosure information not submitted.

Introduction: Multiorgan dysfunction scoring systems, including the Pediatric Logistic Organ Dysfunction-2 (PELOD-2), are used to predict mortality in pediatric intensive care unit (PICU) populations. We have previously shown that the day 1 PELOD-2 score has good discrimination & calibration in the subset of critically ill pediatric trauma patients. This study aims to assess the performance of the PELOD-2 score in this subpopulation on subsequent ICU admission days and evaluate if this score can be utilized as an outcomes measure for future clinical trials.


Methods: Pediatric trauma patients admitted to the PICU of a single tertiary care center between January 2021 and March 2024 were included. Patient demographics, injury characteristics, and PELOD-2 scores were extracted from the electronic medical record. PELOD-2 performance for predicting mortality at day 1, day 3, and day 5 during intensive care admission was assessed. Discrimination was measured using the area under the receiver operating characteristic curve (AUROC) and the area under the precision–recall curve (AUPRC), with the latter providing added value in imbalanced datasets. Calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test.


Results: Of 589 pediatric trauma patients, hospital mortality was 5.7% (34/589). PELOD-2 scores during ICU admission were significantly higher among non-survivors than survivors at d1 (18.0, interquartile range [14.5, 19.0] vs. 2.0 [0, 4.0]), d3 (14.0 [12.0, 17.0] vs. 0 [0, 3.0]), and d5 (14.5 [12.0,17.0] vs. 0 [0, 4.5]); p< 0.001. The PELOD-2 scores had strong discrimination at day 1, day 3, and day 5 with AUROC values of 0.88 (95% confidence interval, (0.69 –1.0), 0.91( 0.84 –0.89), and 0.96 (0.94 –0.99) and corresponding AUPRCs of 0.65 (0.47 -0.84), 0.88 (0.76 –0.96), and 0.79 (0.59 –0.94). Calibration of the PELOD-2 scores at day 1, day 3, and day 5 were also adequate at p=0.24, p=0.83, and p=0.93.


Conclusions: The PELOD-2 score demonstrated strong discrimination and acceptable calibration at day 1, day 3, and day 5 post-trauma, indicating robust predictive performance for mortality in pediatric trauma patients. Validation of these results are required in larger multi-center populations. These findings support the use of PELOD-2 as an outcomes measure in future trauma-focused clinical trials.