Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Martha, Vanessa Feller; García, Pedro Celiny Ramos; Piva, Jefferson Pedro; Einloft, Paulo Roberto; Bruno, Francisco; Rampon, Viviane

doi:10.2223/1348

Cited by 29 publications

(28 citation statements)

References 27 publications

(23 reference statements)

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“…(17) Aiming to compare the diagnoses that resulted in hospitalization in a PICU according to organic dysfunction, we verified in the literature differences with a greater proportion of cardio-circulatory dysfunctions (30%) followed by respiratory (27%) and neurological (22%) dysfunctions. (12) Respiratory dysfunctions predominated in this study.…”

Section: Discussionmentioning

confidence: 56%

“…(15) The median age found in this study was children younger than two years old while most were male. Other studies report a higher percentage at an older age in relation to the age of the sample in intensive care, that is, 44.3 months (12) and 8.5 years old in international study. (16) Similar results concerning gender were also verified in an epidemiological study conducted in a PICU.…”

Section: Discussionmentioning

confidence: 76%

“…It is a reliable indicator of severity that was validated by the authors (12) and used in the institution during the study. SMR corresponds to the ratio between observed and expected mortality and its variation, assessed according to standard deviation, the values of which confirm the hypothesis that observed mortality is equal to the expected when ±1.96.…”

Section: Methodsmentioning

confidence: 99%

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Validação Concorrente de Escores de Enfermagem (NEMS e TISS-28) em terapia intensiva pediátrica

et al. 2013

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Objective: Examine the concurrent validity of the Nine Equivalents of Nursing Manpower Use Score (NEMS) in comparison to the Therapeutic Intervention Scoring System-28 (TISS-28) in a Pediatric Intensive Care Unit (PICU). Methods: Prospective observational cohort study conducted in a PICU of a Brazilian university hospital over a period of two years with a sample of 816 patients. A total of 7,702 observations were obtained for each of the scores. Results: The average maximum score of the NEMS was 26.6±9.2 and for the TISS-28 it was 21.3±8.2. The TISS-28 was lower than the NEMS (p<0.001) for all the averages. A good correlation was observed between them (r2=0.704) for all observations. Agreement between the TISS-28 and the NEMS was good, presenting only a 6.2% difference between the scores. Conclusion: The results show good correlation and agreement between the TISS-28 and the NEMS, enabling the NEMS validation in this population of pediatric patients. Resumo Objetivo: Examinar a validade concorrente do escore Nine Equivalents of Nursing Manpower Use Score (NEMS) em comparação ao Therapeutic Intervention Scoring System-28 (TISS-28) em uma Unidade de Terapia Intensiva Pediátrica (UTIP).Métodos: Estudo de coorte prospectivo observacional, realizado na UTIP de um hospital universitário brasileiro, no período de dois anos, com uma amostra de 816 pacientes. Foram realizadas 7.702 observações de cada um dos escores. Resultados: A média da pontuação máxima do NEMS foi 26,6±9,2 e do TISS-28 21,3±8,2. Em todas as médias, o TISS-28 foi inferior ao NEMS (p<0,001). Houve uma boa correlação entre eles (r 2 =0,704 para todas as observações). A concordância entre o TISS-28 e o NEMS foi boa, apresentando apenas 6,2% de diferença entre os escores. Conclusão: Os resultados mostraram boa correlação e concordância entre o TISS-28 e o NEMS, permitindo validar o NEMS nessa população de pacientes pediátricos.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 76%

Section: Methodsmentioning

confidence: 99%

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Validação Concorrente de Escores de Enfermagem (NEMS e TISS-28) em terapia intensiva pediátrica

et al. 2013

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“…Therefore, the aim of PICU to suppress the number of deaths (mortality) and the rate of disability (morbidity) can be achieved. [1][2][3] Technology advances in PICU resulted to a more sophisticated care for children, therefore making the PICU prepared to treat cases of high complexity at high cost. However, the technology available has no always succeeded in improving the quality of patient care and to augment life expectancy.…”

Section: Introductionmentioning

confidence: 99%

Prognostic predictor at Pediatrics Intensive Care Unit (PICU) with Pediatric Risk of Mortality III (PRISM III) scores

Susianawati¹,

Suryantoro

Naning

2014

JMedScie

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Various mortality prognostic scoring system are available for predicting mortality risk in Pediatric Intensive Care Unit (PICU). The Pediatric Risk of Mortality III (PRISM III) scoring system is one of the main indicators used in the PICU. This study was conducted to evaluate the PRISM III as prognostic predictor in PICU. This was a cohort study involving 64 patients who admitted to PICU in Dr. Sardjito General Hospital, Yogyakarta and met inclusion and exclusion criteria. The clinical state of patients were assessed and the PRISM III scores corresponding to the firs 24 hours of hospitalization were calculated. Outcome analysis was defined either as death or discharged from the hospital were recorded. Multivariate analysis was performed to find out independent predictive factor that influence the outcome of death. The discriminative power of the model was calculated based on the receiver operator curve (ROC). The result showed that mental status (relative risk/RR: 13.21; 95%CI: 1.18-14.80), White Blood Count/WBC (RR: 19.51; 95%CI: 18.12-25.15) and Blood Urea Nitrogen/BUN (RR:22.87; 95%CI:1.85-28.20) were found to be the main predictive factors of death in PICU. The cut off value of 51 of PRISM III score yielded the best sensitivity (83%) and specificity (69%). In conclusion, PRISM III score can be used as a prognostic predictor to determine the death risk of patients hospitalized at PICU. ABSTRAKBerbagai sistem penilain prognosis mortalitas tersedia untuk memprediksi risiko kematin di Uni Perawatan Insentif Anak (UPIA). Sistem penilaian Pediatric Risk of Mortality III (PRISM III) merupakan salah satu indikator utama yang digunakan di UPIA. Penelitian ini dilakukan untuk mengkaji PRISM III sebagai pridiktor prognosis di UPIA. Penelitian ini merupakan penelitian kohort yang melibatkan 64 pasien anak yang dirawat di UPIA RSUP Dr. Sardjito, Yogyakarta yang memenuhi kriteria inklusi dan eksklusi. Kondisi klinik pasien diperiksa dan nilai PRISM III pada 24 jam pertama sejak dirawat di rumah sakit dihitung. Analisis multivariat dilakukan untuk mencari faktor prediktif independen yang mempengaruhi kematian. Kekuatan pembeda model dihitung berdasarkan receiver operator curve (ROC). Hasil penelitian menunjukkan status mental (Relative Risk/RR: 13,21; 95% Confidence Interval/CI: 1,18-14,80), jumlah leukosit (RR: 19,51; 95%CI: 18,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)15) and nitrogen urea darah (RR:22,87; 95%CI:1,20) terbukti merupakan faktor prediktif utama kematian di UPIA. Nilai titik potong 50 dari skor PRISM III memberikan senstitivitas (83%) dan spesifisitas (69%) terbaik. Dapat disimpulkan, skor PRISM III dapat digunakan sebagai prediktor prognostik untuk menentukan risiko kematian pasien yang dirawat di UPIA.

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“…4 Since they compare mortality adjusted by disease severity, these scores can also be used for comparisons between clinical trials and for planning technological resources in this area. 1,6,7 Mortality and length of hospital stay are examples of the most used outcomes. Scoring systems are arrived at evaluation of the patient's mortality risk in the ICU by assigning a score to patient and predicting the outcome.…”

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confidence: 99%

A Cross-Sectional Study to Evaluate the Outcome of Patients Admitted to Paediatric Intensive Care Unit by Using Paediatric Multiple Organ Dysfunction Score (P-Mods) at Kles Tertiary Care Hospital and Mrc, Belgaum

Batt¹,

M²

2017

jemds

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BACKGROUNDObjectives-Mortality in PICU is related to the number of organ dysfunction. The PMOD score as a continuous variable, which defines and predicts the number of organ dysfunction in successive day of ICU stay can be a good alternative to other scoring systems such as PIM and PRISM use as a surrogate for prediction of mortality in PICU.The present study was planned in an attempt to evaluate the outcome of patients admitted to PICU by using Paediatric Multiple Organ Dysfunction Score (P-MODS). MATERIALS AND METHODSThis one-year cross-sectional study was done in the PICU under the Department of Paediatrics, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from January 2014 to December 2014. During the study period, there were a total of 694 admissions in PICU of which eligible 100 were studied. RESULTSOf the 100 children studied, 59% of the children were boys with boy to girl ratio of 1.43:1 and more than one-third of the children (37%) were aged < 1 year and the mean age was 4.65 ± 4.60 years. 56% of the children were from Class II socioeconomic status according to modified B. G. Prasad's classification. The mortality rate was 18%. MODS was noted in 74% of the children and mortality was significantly associated with MODS (p= 0.001). Ventilatory support was noted in 24% of the children. In majority of the children (70%), the length of hospital stay was ≤ 3 days. Most of the children (42%) had P-MOD score of 4 to 7. The mean PMOD scores among the non-survivors were significantly high compared to non-survivors (p < 0.001). The percentage of death in children with 0 to 3 P-MOD scores was 3.3%, which was high reaching 60% among the children with P-MOD scores of ≥ 12. The mean PMOD scores increased significantly with increase in organ involvement (p < 0.001). Using the cut-off point of 7.5, PMOD score showed higher sensitivity (77.78%) and specificity (82.93%) in predicting outcome. CONCLUSIONPMOD score strongly correlates with the PICU mortality and no. of organ dysfunction and can be used in PICU for the prediction of outcome.

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Comparison of two prognostic scores (PRISM and PIM) at a pediatric intensive care unit

Cited by 29 publications

References 27 publications

Validação Concorrente de Escores de Enfermagem (NEMS e TISS-28) em terapia intensiva pediátrica

Validação Concorrente de Escores de Enfermagem (NEMS e TISS-28) em terapia intensiva pediátrica

Prognostic predictor at Pediatrics Intensive Care Unit (PICU) with Pediatric Risk of Mortality III (PRISM III) scores

A Cross-Sectional Study to Evaluate the Outcome of Patients Admitted to Paediatric Intensive Care Unit by Using Paediatric Multiple Organ Dysfunction Score (P-Mods) at Kles Tertiary Care Hospital and Mrc, Belgaum

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