Validity of PRISM Score in Predicting Mortality in a Tertiary Care Hospital in North India

Hassan, Zul Eidain; Quyoom, Irfan; Mushtaq, Iqbal

doi:10.21276/ijcmr.2018.5.9.16

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…Roy et al, where infection and respiratory diseases are the commonest indications of PICU admission. 17 In the present study, overall mortality among PICU admission was 18.75% (27 out of 144) which is comparable to other PICUs in recent times as reported by Singhal et al, Madaan et al, and Hassan et al, with mortality rates of 18%, 12.5%, and 17%, respectively 9,18,19. …”

supporting

confidence: 81%

An observational study to evaluate the outcome of patients admitted in pediatric intensive care unit (PICU) using pediatric risk of mortality (PRISM-III) score in a tertiary care hospital of West Bengal

et al. 2023

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Background: Pediatric risk of mortality (PRISM III) score is used across the globe to predict the mortality of hospitalized children by an objective method based on 17 variables measured during first 24 h of admission in pediatric intensive care unit (PICU). Aims and Objectives: We have done this study to evaluate the cause, management and outcome of PICU admissions and also to find out the statistical significance of PRISM III score in predicting mortality. Materials and Methods: This observational prospective study was conducted for a period of 1 year in the PICU of a district Medical College of West Bengal among children 1–12 years age. They were divided into 4 groups according to the PRISM III scores of 1–10, 11–20, 21–30, and >30 and outcome in all the groups were recorded and analyzed. Results: Respiratory (25%), neurological (20.1%), and infectious (17.3%) etiology were major cause of PICU admission. About 17.4% patients needed mechanical ventilation, 31.2% Continuous Positive Airway Pressure and 66% patients inotropic support. Out of 144 cases, 117 discharged and 27 expired. Percentage of death is 100%, 44.4%, 21.6%, and 4.6% among child with PRISM III score of >30, 21–30, 11–21, and ≤10, respectively. Significant increase in mortality noted with increase in number of organ failures. Specificity and positive predictive value increases with higher PRISM III score and sensitivity and negative predictive value is more with low PRISM III score. Conclusion: PRISM III score can be used as a triage tool in limited resource settings for early initiation of intense management to high risk and salvageable cases.

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supporting

confidence: 81%

An observational study to evaluate the outcome of patients admitted in pediatric intensive care unit (PICU) using pediatric risk of mortality (PRISM-III) score in a tertiary care hospital of West Bengal

et al. 2023

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“…In the PICU, scoring systems help healthcare managers determine a patient's prognosis and improve the decision-making process as well as the patient's outcome [9,17]. In a country like Pakistan, where tertiary care institutions are few, the outcome of PICU estimates the most effective use of limited resources and helps guide policy formation [3].…”

Section: Discussionmentioning

confidence: 99%

“…However, developing the optimal scoring method for critically ill children admitted to the PICU remains a challenging task [19]. Different methods are used in PICUs for the prediction of severity of disease and risk of mortality, including Pediatric Index of Mortality (PIM and PIM2), Pediatric Risk of Mortality (PRISM, PRISM III), Sequential Organ Failure Assessment (SOFA), Pediatric Sequential Organ Failure Assessment Score (p-SOFA), and the Paediatric Logistic Organ Dysfunction (PELOD) score [1,2,[5][6][7][8][9]. Although these scoring systems are effective in ICUs all over the world, it is important to evaluate them before using them in healthcare settings that are very different from where they were established [3,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…Several prognostic scoring systems like Pediatric Index of Mortality (PIM and PIM2), Pediatric Risk of Mortality (PRISM, PRISM III), Sequential Organ Failure Assessment (SOFA), Pediatric Sequential Organ Failure Assessment Score (p-SOFA), and the Paediatric Logistic Organ Dysfunction (PELOD) score have been developed to predict PICU children's morbidity and death, which can be extremely helpful in treatment planning [1,2,[5][6][7][8][9]. The PRISM III 24 score is a commonly used system that is used to evaluate various scoring systems.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Pediatric Sequential Organ Failure Assessment and Pediatric Risk of Mortality III Score as Mortality Prediction in Pediatric Intensive Care Unit

Baloch¹,

Shaikh²,

Gowa³

et al. 2022

Cureus

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Objective: To assess and compare the diagnostic accuracy of the Pediatric Risk of Mortality (PRISM) III score and Pediatric Sequential Organ Failure Assessment (p-SOFA) for the prediction of mortality in critically ill children.Methodology: This was a cross-validation study conducted at the Pediatric Intensive Care Unit (PICU) of the National Institute of Child Health Karachi from February 2021 to July 2021. Two hundred eighty-six critically ill children of age one month to 15 years of either gender staying in PICU for more than 24 hours were included. Within 24 hours of admission, the p-SOFA and PRISM III 24 scores were calculated for all eligible children. The outcome of the study was mortality within 30 days of PICU admitted children. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23.Results: The median age was 24 months (range: 1-144 months). The 30-day mortality was estimated as 57%. The p-SOFA and PRISM scores were significantly greater in children who did not survive than survivors. The maximum p-SOFA score (area under the curve (AUC)=0.81, 95% CI=0.76-0.86, p=0.001) and PRISM III 24 score (AUC=0.75, 95% CI=0.69-0.81, p=0.001) had good discrimination for 30-day mortality. For the prediction of 30-day mortality at the cut-off value of p-SOFA>2, the sensitivity was 93.87%, specificity was 38.21%, and accuracy was 69.93%. Whereas at the cut-off value of PRISM III 24 score>8, the sensitivity was 55.83%, specificity was 77.24%, and accuracy was 65.03%. Conclusion:The p-SOFA score is a good predictor for 30-day mortality in critically ill children and had better accuracy than the PRISM III 24 score.

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“…The PRISM-III cut-off score for mortality in our study was 9.5. Hasan ZE, et al 21 concluded that a PRISM-III score >8 was a significant predictor of mortality with an odd's ratio of 9.28 for mortality. An Egyptian study 22 done in patients with end stage liver disease and fulminant hepatic failure also got a PRISM cut-off score of 9.5.…”

Section: Discussionmentioning

confidence: 99%

Comparison between paediatric risk of mortality III and paediatric logistic organ dysfunction-2 as mortality predictor in paediatric intensive care

Shenoy¹,

Patil²,

Karunakar³

et al. 2023

Sri Lanka J Child Health

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Background: Scoring systems in an intensive care unit (ICU) help in monitoring the patient, evaluating the performance of the ICU and in determining the prognosis of the patient. Pediatric Logistic Organ Dysfunction-2 (PELOD-2) is a new scoring system describing organ dysfunction in paediatric intensive care unit (PICU) which has gained importance as a mortality predictor.Objectives: To assess the performance of PELOD-2 in predicting mortality and compare it with Pediatric Risk of Mortality-III (PRISM-III) scoring system.Method: This prospective observational study was carried out in a tertiary care PICU. All consecutive patients with critical illness were scored according to the 2 scoring systems within 24 hours of admission and followed up until discharge or death. Patients admitted for post-surgical care, PICU stay less than 2 hours, death within 8 hours of admission and patients leaving against medical advice were excluded from the study.Results: A total of 550 patients with critical illness was included in study with a median (IQR) age of 60 (12,132) months and a M: F ratio of 1.6. Predicted mortality using PELOD-2 and PRISM-III score was 62 and 63 patients respectively whereas actual mortality was 67 patients. Area under the ROC was 0.992 for PELOD-2 and 0.98 for PRISM-III with a mean difference of 0.0118 with 95% CI (0.00325 to 0.0204) p value of 0.007. Hosmer and Lemeshow goodness of fit test also showed good calibration in predicting mortality for both scoring systems (PELOD-2: ꭓ 2 = 6.051, p value of 0.301, PRISM-III -ꭓ 2 = 9.391, p value= 0.153

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Validity of PRISM Score in Predicting Mortality in a Tertiary Care Hospital in North India

Cited by 4 publications

References 9 publications

An observational study to evaluate the outcome of patients admitted in pediatric intensive care unit (PICU) using pediatric risk of mortality (PRISM-III) score in a tertiary care hospital of West Bengal

An observational study to evaluate the outcome of patients admitted in pediatric intensive care unit (PICU) using pediatric risk of mortality (PRISM-III) score in a tertiary care hospital of West Bengal

Comparison of Pediatric Sequential Organ Failure Assessment and Pediatric Risk of Mortality III Score as Mortality Prediction in Pediatric Intensive Care Unit

Comparison between paediatric risk of mortality III and paediatric logistic organ dysfunction-2 as mortality predictor in paediatric intensive care

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