, Afin d'avoir une meilleure puissance statistique, les scores Risk et Injury (Risk-Injury) ont été regroupés

, Le score de RIFLE a montré une différence significative sur l'évolution défavorable à J60 : le groupe Risk-Injury avait un OR 2

, De même, la transplantation et la mortalité à J28 avaient respectivement, pour le groupe RiskInjury

. La-courbe-de-survie-kaplan, Meier à J28 montre une différence de survie significative en fonction des trois groupes : pas d'atteinte rénale / Risk-Injury / Failure (Fig, vol.14

, Pediatric Index of Mortality) est un score de sévérité à l'admission en réanimation, vol.56, p.2

, ? Pression artérielle systolique, mmHg (inconnu=120)

, ? Reflexes photomoteurs (>3 mm et aréactives =1, autre ou inconnu=0

?. Pao2, mmHg (inconnu=0) FIO2 lors de la mesure du PaO2 si oxygène (inconnu=0)

, ? Ventilation mécanique lors de la 1 ère heure en PICU (non=0, oui=1)

, ? Admission programmée en PICU (non=0, oui=1)

, ? Post-opératoire en motif d'admission en PICU (non=0, oui=1)

, ? Circulation extra-corporelle (non=0, oui=1)

?. Diagnostic-À-haut-risque, Arrêt cardiaque / Déficit immunitaire combiné sévère / Leucémie ou lymphome après première induction / Hémorragie cérébrale spontanée / Cardiomyopathie ou myocardite / Hypoplasie ventriculaire gauche / Séropositivité HIV / Défaillance hépatique / Atteinte neuro-dégénérative ? Diagnostic de bas risque

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. Titre, Nous souhaitions évaluer (i) le pronostic et (ii) les facteurs prédictifs de mortalité à J28 et J60 chez des enfants admis en réanimation pédiatrique sans antécédent de transplantation hépatique, Facteurs prédictifs des patients cirrhotiques en réanimation pédiatrique, greffés exclus Les données disponibles concernant les enfants cirrhotiques admis en réanimation pédiatrique sont rares

, Nous avons enregistré les données cliniques et biologiques à l'admission et à J7 ainsi que les évènements notables lors de l'hospitalisation. L'index pédiatrique de mortalité (PIM 2), le score de RIFLE (insuffisance rénale aiguë), le Pediatric End-Stage Liver Disease score (PELD) et le score de défaillances d'organes adapté à la cirrhose (pCLIF SOFA) ont été calculés lors de l'hospitalisation en réanimation, Nous avons réalisé une étude rétrospective multicentrique chez des patients cirrhotiques admis en réanimation entre 2011 et 2016 (groupe de recherche de l'ESPNIC)

, ) et un score ?9 prédisait la mortalité à J28 avec une sensibilité de 87.8% et une spécificité de 77.3%. Ni le Pediatric Index of Mortality score (PIM2) ni le Pediatric End-Stage, 51% ont eu une issue défavorable à J60. Des facteurs de risques significatifs d'évolution défavorable étaient : un international normalized ratio élevé

. Alors-que-le-score-de-défaillance-rénale, RIFLE (Risk, Injury, Failure, Loss, End-stage), était associé significativement à la mortalité à J28 (Failure : OR 18

, Cinquante et un pourcent de patients cirrhotiques admis en réanimation pédiatrique avaient une issue défavorable

, Le sepsis et une défaillance hépatique aiguë sur chronique étaient des facteurs indépendants de mortalité. Le pCLIF-SOFA s'avère fiable pour prédire un pronostic défavorable à J28 et J60

A. Mots-clés:-cirrhose, . Sepsis, . Bilirubine, C. Inr, E. Réanimation et al., Predictive factors of cirrhotic children in pediatric intensive care, transplanted excluded Data on pediatric intensive care unit (PICU)-admitted cirrhotic patients is scarce. We aimed to evaluate the (i) prognosis and (ii) predictive factors for 28-day and 60-day poor outcome (eg mortality, liver transplantation) in children admitted in PICU without previous liver transplantation. We performed a multicentric retrospective analysis of pediatric cirrhosis patients admitted into four critical care units between 2011-2016 (ESPNIC research network group). We recorded clinical and biological data at admission then day 7 and followed the patients until discharge. Pediatric index of mortality (PIM2), RIFLE score (acute renal failure), Pediatric End-Stage Liver Disease score (PELD) and pediatric chronic liver failure sequential organ failure assessment score (pCLIF SOFA) were computed during ICU stay

, ) and sepsis (OR 2day mortality with a sensitivity of 87.8% and a specificity of 77.3%. Neither the Pediatric Index of Mortality score (PIM2) or the Pediatric End-Stage Liver Disease score (PELD) score were discriminant, A total of 130 patients were enrolled (mean age of 21 months) and 51% had a poor outcome at 60-day. Significant risk factors for poor outcome were high international normalized ratio

, Sepsis and acute-onchronic liver failure are independent predictors of outcome. pCLIF-SOFA is a reliable score in prognostication of 28 mortality or 60-day poor outcome. Keywords: Cirrhosis, ACLF, Sepsis, Bilirubin, INR, CLIF-SOFA, Intensive Care, Children Université Paris Descartes Faculté de Médecine Paris Descartes 15, PICU have a poor outcome