Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study

Hwang, Hui Seung; Lee, Na Young; Han, Seung Beom; Kwak, Ga Young; Lee, Soo Young; Chung, Seung Yun; Kang, Jin Han; Jeong, Dae Chul

doi:10.3345/kjp.2008.51.11.1158

Cited by 11 publications

(9 citation statements)

References 21 publications

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“…20,21 Majority of the patients were admitted directly to the paediatric intensive care unit without any significant influence on the outcome which was similar to the observation shown in studies conducted in developed countries. 22,23 In the present study, the observed mortality rate was 9.3%. PIM II and PRISM III underestimated the mortality with a predictive mortality rate of 4.6% (SMR 1.32) and 5.6% (SMR 1.64) respectively.…”

Section: Discussionsupporting

confidence: 51%

“…24 Leteurteet al 24 also demonstrated the under prediction of mortality by the scores. Contrary to these observations, studies from developed countries have shown accurate prediction of mortality using these scores, 22,23,28,29,30,31 a Korean study 23 showed the predictive mortality rate of 13.9% (SMR 1) and with 14.1% (SMR 0.99) using PIM II and PRISM III respectively versus the observed mortality rate of 14%. 23 Martha et al 31 also demonstrated similar observation.…”

Section: Discussionmentioning

confidence: 90%

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A Prospective Cohort Study for the Comparison of Two Prognostic Scores-Prism 3 and Pim 2 in a Paediatric Intensive Care Unit

Bhupal¹,

Patil²,

Bellad³

et al. 2014

jemds

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BACKGROUND AND OBJECTIVES: Various prognostic scores are used to evaluate the outcome in the PICU. Among these scores PRISM (Pediatric Risk of Mortality) and PIM (Pediatric Index of Mortality), are the most recent versions. The objectives of this study were to compare performance of PIM II and PRISM III scores at a general pediatric intensive care unit, relation between observed mortality and survival and predicted mortality and survival. METHODS: Present prospective cohort study was conducted at Pediatric Intensive Care Unit, KLES, Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during period of July-2009 to October-2009. Ethical clearance was obtained from Ethical and Research Committee of Jawaharlal Nehru Medical College, Belgaum. A total of 316 patients were enrolled out of 350 admissions during study period. Within first hour of admission PIM II was assessed and at 24 hours PRISM III score was assessed. Patients were followed up for outcome measured in form of survivors and non survivors. RESULTS: A total 316 patients were enrolled, 28 patients were excluded as their outcome was not known. Among the 288 patients 261 were survivors and 27 were non-survivors. Majority of survivors and non survivors were males but there was no statistical significant influence on outcome. The overall number of estimated mortality was 13.2 and 16.5 with PIM II and PRISM III respectively compared to observed mortality of 27. PIM II (x 2 =16.34; p<0.001) and PRISM III (x 2 =6.78; p=0.009) had poor calibration. PRISM III showed the better discrimination (ROC=0.892) followed by PIM II 0.871 (0.827 to 0.907). PIM II and PRISM III (0.850 to 0.925) revealed positive and significant correlation, with spearman's rank correlation (r= 0.318; p<0.0001). INTERPRETATION AND CONCLUSION: In this study PIM II and PRISM III under predicted mortality and also had poor calibration with good discrimination. Overall both scores exhibited good capacity to discriminate between survivors and non survivors and can be used as a tool with comparable performance for prognostic evaluation.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 90%

A Prospective Cohort Study for the Comparison of Two Prognostic Scores-Prism 3 and Pim 2 in a Paediatric Intensive Care Unit

Bhupal¹,

Patil²,

Bellad³

et al. 2014

jemds

View full text Add to dashboard Cite

show abstract

“…There have been many trials to assess several pediatric mortality scores (including the Pediatric Index of Mortality [PIM] 2) with satisfactory results (2-6). However, these scores still require an assessment of consciousness, vital signs, and numerous laboratory data.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Usefulness of Eosinopenia in the Pediatric Intensive Care Unit

et al. 2013

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Eosinopenia, a biomarker for infection, has recently been shown to be a predictor of adult mortality in the intensive care unit (ICU). Our study assessed the usefulness of eosinopenia as a mortality and an infection biomarker in the pediatric ICU (PICU). We compared the PICU mortality scores, eosinophil count and percentage at ICU admission between children who survived and those who did not survive and between children with infection and those without infection. A total of 150 patients were evaluated. The initial eosinophil count and percentage were significantly lower in the group that did not survive when compared to those that did survive (P < 0.001; P < 0.001). However, there was no significant difference in the eosinophil count and percentage seen in patients with and without infection. Eosinopenia, defined as an eosinophil count < 15 cells/µL and an eosinophil percentage < 0.25%, (hazard ratio [HR]: 2.96; P = 0.008) along with a Pediatric Index of Mortality (PIM) 2 (HR: 1.03; P = 0.004) were both determined to be independent predictors of mortality in the PICU. The presence of eosinopenia at the ICU admission can be a useful biomarker for mortality in children, but is not useful as a biomarker for infection.

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“…9 In Korea, a retrospective study identified a good calibration of PIM2 among pediatric patients admitted to intensive care (Hosmer-Lemeshow v 2 = 14.986; P = 0.308). 16 The present study demonstrates as well a good discriminatory ability of PIM2 to differentiate survivors from non-survivors (AUC 0.796, 95% CI 0.675 to 0.916, P < 0.001). This observation is in agreement with many studies.…”

Section: Discussionmentioning

confidence: 66%

Assessment of the performance of the Pediatric Index of Mortality 2 (PIM2) among Egyptian pediatric patients admitted to the intensive care

Youssef

Mosleh

Labib

2014

Egyptian Pediatric Association Gazette

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Background: Mortality prediction models are useful in pediatric intensive care units (PICUs) as risk assessment tools and as a benchmark for the quality of care. Objectives: To assess the performance of the Pediatric Index of Mortality 2 (PIM2) in terms of calibration and discrimination between survivors and non-survivors among pediatric patients. Methods: This is a cohort prospective study including 317 pediatric patients admitted to two PICU settings in a tertiary care hospital in Egypt over a period of one year (from June 2012 till June 2013). Collected data included personal characteristics, hospital data, diagnosis, outcome and variables included in PIM2 scoring. Results: Non-survivors constituted 8.5%. Most common diagnosis was respiratory diseases (47.9%). Only CNS morbidities (11.7% of survivors versus 37% of non-survivors, P = 0.001) and a higher PIM2 score (2.39 ± 5.49 in survivors versus 41.38 ± 36.06 in non-survivors, P = 0.001) were associated with increased risk of non-survival. The area under the curve (AUC) for PIM2 is 0.796 (95% CI 0.675-0.916), P < 0.001. The Hosmer-Lemeshow goodness-of-fit was 2.850, 8 df, P = 0.943. PIM2. Conclusion: The calibration and the discriminative ability of PIM2 scoring system aiming to distinguish survivors from non-survivors are satisfactory for this sample of pediatric patients. PIM2 is easily calculated and is freely available. Thus, this tool provides a good incentive for ICU settings in Egypt for admission of high risk patients in the light of the limited PICU bed complement capacity in relation to the demands.

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Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study

Cited by 11 publications

References 21 publications

A Prospective Cohort Study for the Comparison of Two Prognostic Scores-Prism 3 and Pim 2 in a Paediatric Intensive Care Unit

A Prospective Cohort Study for the Comparison of Two Prognostic Scores-Prism 3 and Pim 2 in a Paediatric Intensive Care Unit

Prognostic Usefulness of Eosinopenia in the Pediatric Intensive Care Unit

Assessment of the performance of the Pediatric Index of Mortality 2 (PIM2) among Egyptian pediatric patients admitted to the intensive care

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