Application of different scoring systems and their value in pediatric intensive care unit

Abstract

Background: Little is known on the impact of risk factors that may complicate the course of critical illness. Scoring systems in ICUs allow assessment of the severity of diseases and predicting mortality. Objectives: Apply commonly used scores for assessment of illness severity and identify the combination of factors predicting patient's outcome. Methods: We included 231 patients admitted to PICU of Cairo University, Pediatric Hospital. PRISM III, PIM2, PEMOD, PELOD, TISS and SOFA scores were applied on the day of admission. Follow up was done using SOFA score and TISS. Results: There were positive correlations between PRISM III, PIM2, PELOD, PEMOD, SOFA and TISS on the day of admission, and the mortality rate (p < 0.0001). TISS and SOFA score had the highest discrimination ability (AUC: 0.81, 0.765, respectively). Significant positive correlations were found between SOFA score and TISS scores on days 1, 3 and 7 and PICU mortality rate (p < 0.0001). TISS had more ability of discrimination than SOFA score on day 1 (AUC: 0.843, 0.787, respectively). Conclusion: Scoring systems applied in PICU had good discrimination ability. TISS was a good tool for follow up. LOS, mechanical ventilation and inotropes were risk factors of mortality.

Predictive Efficacy of Pediatric Logistic Organ Dysfunction-2 Score in Pediatric Intensive Care Unit of Rural Hospital

“…In our study, inotropes requirement for >6 hours was considered, where those who needed inotrope support consisted of 22 patients out of which 19 died. Inotropes requirement had statistically significant correlation with mortality ( p = 0.0000), corroborating the findings by Rady et al 11 in his study as compared to other studies who found that higher mortality in patients using these drugs. The association of PELOD-2 with outcome obtained suggested maximum mortality in the group with score >15 (66.6%) ( Table 4 ).…”

Factors present on admission associated with increased mortality in children admitted to a paediatric intensive care unit (PICU)

“…[9] The Pediatric Risk of Mortality (PRISM) score uses clinical, physiological and laboratory variables in the first 24 hours of PICU admission, to attain a score assessing severity of illness. [10] Although validated for use in the USA, [11] its validity in an SA population has been questioned. [12] The Paediatric Index of Mortality (PIM) score is a simpler tool using eight parameters to assess mortality risk on admission.…”

A Good Workman Never Blames His Tools: Appropriate Use of Severity of Illness Scoring Systems Determines Their Utility!

“…In this comparison of five scoring systems 6 ( Table 1 ), where score for each patient was calculated on all scoring systems, it was seen that there was very good correlation among all different systems used. Hence, it probably matters very little what system is used in a unit.…”