Association between serum cortisol levels and pediatric logistic organ dysfunction score in critically ill patients

Abstract

Activation of the hypothalamic-pituitary-adrenal axis with the production of cortisol is a fundamental component of the stress response and is essential for survival of the host in critical illness. However, the studies of serum cortisol levels among critically ill children in association with organ dysfunction are still lacking. The aim of the study was to investigate the association between serum cortisol levels and pediatric logistic organ dysfunction (PELOD) score in a group of pediatric intensive care unit patients. We conducted a cross-sectional study of pediatric intensive care unit (PICU) patients at Sanglah Hospital, from February to April 2014. We included children aged 1 to 144 months and subjects were divided into two groups according to PELOD score. Data were analyzed using independent sample t-test and multivariate linear regression analysis. Twenty two children with low PELOD score less than or equal to 10 (group I) were compared to 20 children with high PELOD score more than 10 (group II). Subjects in group II had significantly higher serum cortisol levels compare to group I [mean (SD) 248.8 (172.1) ng/ml versus 138.8 (34.6) ng/ml, P=0.005]. Multivariate linear regression analysis showed that PELOD score (P<0.0001) and stress period (P<0.0001) were associated with serum cortisol levels. In conclusion, high PELOD score was associated with elevated serum cortisol levels.