Patterns of Organ Dysfunction in Critically Ill Children Based on PODIUM Criteria

L. Nelson Sanchez-pinto, Melania M. Bembea, Reid Wd Farris, Mary E. Hartman, Folafoluwa O. Odetola, Michael C. Spaeder, R. Scott Watson, Jerry J. Zimmerman, Tellen D. Bennett, Marie E Steiner

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


OBJECTIVES: The goal of this study was to determine the incidence, prognostic performance, and generalizability of the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) organ dysfunction criteria using electronic health record (EHR) data. Additionally, we sought to compare the performance of the PODIUM criteria with the organ dysfunction criteria proposed by the 2005 International Pediatric Sepsis Consensus Conference (IPSCC). METHODS: Retrospective observational cohort study of critically ill children at 2 medical centers in the United States between 2010 and 2018. We assessed prevalence of organ dysfunction based on the PODIUM and IPSCC criteria for each 24-hour period from admission to 28 days. We studied the prognostic performance of the criteria to discriminate in-hospital mortality. RESULTS: Overall, 22 427 PICU admissions met inclusion criteria, and in-hospital mortality was 2.3%. The cumulative incidence of each PODIUM organ dysfunction ranged from 15% to 30%, with an in-hospital mortality of 6% to 10% for most organ systems. The number of concurrent PODIUM organ dysfunctions demonstrated good-to-excellent discrimination for in-hospital mortality (area under the curve 0.87-0.93 for day 1 through 28) and compared favorably to the IPSCC criteria (area under the curve 0.84-0.92, P < .001 to P = .06). CONCLUSIONS: We present the first evaluation of the PODIUM organ dysfunction criteria in 2 EHR databases. The use of the PODIUM organ dysfunction criteria appears promising for epidemiologic and clinical research studies using EHR data. More studies are needed to evaluate the PODIUM criteria that are not routinely collected in structured format in EHR databases.

Original languageEnglish (US)
Pages (from-to)S103-S110
Issue number1
StatePublished - Jan 1 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 by the American Academy of Pediatrics.


Dive into the research topics of 'Patterns of Organ Dysfunction in Critically Ill Children Based on PODIUM Criteria'. Together they form a unique fingerprint.

Cite this