Performance of PRISM (Pediatric Risk of Mortality) score and PIM (Pediatric Index of Mortality) score in a tertiary care pediatric ICU

Abstract

Both PRISM and PIM scores have a good discriminatory performance. The calibration with PRISM score is good but the PIM score displays poor calibration.

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

“…The SMRs for PRISM, PELOD and PIM3 were 2.5, 4.8 and 3.3, respectively. These rates are higher than those found in the Netherlands [8] (0.95 with PRISM and 0.88 with PIM) while in India Taori et al [9] reported an SMR of 1 with PRISM. Wells et al [12] suggested that the different demographic characteristics and disease patterns of SA ICU patients may influence PRISM scoring.…”

“…[16] This is lower than other middle-income countries such as Egypt (33.1%) [17] Saudi Arabia (37.4%) [11] and India (24.3%). [9] In China, however, this figure drops to 2.64%, [18] which is more in keeping with high-income countries where rates are generally <10%. The Netherlands, USA and Australia have total mortality rates of 6.6%, 4.86% and 4.25%, respectively.…”

“…[9] Solomon et al [19] commented that PIM and PIM2 should not be used as screening tools as they are not accurate enough. The scores may need to be recalibrated or recalculated for the SA population [11] to more accurately determine disease severity.…”

“…[8] They can thus aid the optimal use of PICU resources by evaluating the quality of medical care received. [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.…”

Role of probiotics in prevention of hospital acquired pneumonia in Egyptian children admitted to Pediatric Intensive Care Unit of Mansoura University Childrens Hospital

“…All the study participants were subjected to careful history taking, clinical examination, other demographic information, pediatric risk of mortality; (PRISM) score (Taori et al, 2010), laboratory investigations including complete blood count and C-reactive protein, monitoring for HAP, blood cultures, tracheal aspirates and quantitative broncho-alveolar lavage cultures. Tracheal aspirate cultures, blood cultures, and complete hemogram, were emitted every three day.…”